脑儿童阻塞性睡眠呼吸暂停的腺切除术:风险和益处
Nikolaus E Wolter1, Patrick Scheffler2, Chantal Li1
1Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
International journal of pediatric otorhinolaryngology
|September 25, 2023
概括
腺切除术可以改善脑儿童的阻塞性睡眠呼吸暂停 (OSA),但他们面临更高的并发症风险. 运动和吞障碍增加了手术后的呼吸问题.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科肺病学 儿科肺病学
- 儿科神经学 儿科神经学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 在患有脑麻 (CP) 的儿童中很普遍.
- 腺切除术是OSA的常见治疗方法,但CP群体的结果需要进一步调查.
- 在CP中,运动和吞障碍可能会影响手术结果和并发症率.
研究的目的:
- 评估腺切除术在治疗儿童脑膜炎的OSA中的有效性.
- 评估运动和吞功能障碍对患有CP的儿童腺切除术后呼吸道并发症的影响.
- 为了比较患有CP的儿童与没有CP的年龄匹配对照之间的结果.
主要方法:
- 在2003年至2021年期间接受了腺切除术的CP和睡眠呼吸障碍 (SDB) 的儿童的回顾性评估.
- CP 患者与没有 CP 的对照组的年龄匹配.
- 使用总运动功能分类系统 (GMFCS) 评估运动功能,使用饮食能力分类系统 (EDACS) 评估吞功能.
主要成果:
- 49%的CP儿童被评估为中度至重度的OSA;30%接受了腺切除术.
- 腺切除术导致所有患有CP的儿童的阻塞性呼吸暂停-呼吸暂停指数 (OAHI) 最初显著降低.
- 与对照组相比,患有CP的儿童患上术后并发症 (43.5%) 和呼吸道并发症 (OR 8.9) 的比率较高.
- 严重的运动 (GMFCS 5) 和吞 (EDACS 3-5) 障碍与手术后增加的呼吸道并发症有关.
结论:
- 腺切除术改善了CP儿童的OAHI,但他们经历了更高的并发症率.
- 呼吸道并发症在患有严重运动和吞障碍的儿童中更为频繁.
- 这些发现有助于手术前规划和护理人员和临床医生的风险分层.
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