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在肥胖的儿科桃体切除患者中早期的不良呼吸系统结果
Kathryn Wie1, Nicholas Zaccor1, Jonathan Zou2
1Department of Otolaryngology, University of Rochester, Rochester, New York, USA.
概括
接受桃体切除术的肥胖儿童很少经历呼吸系统不良事件 (ARE). 手术前的多睡眠图 (PSG) 发现,如阻塞性呼吸暂停-呼吸暂停指数 (oAHI) 和氧和度 (SpO2),比身体质量指数 (BMI) 更好地预测AREs.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科麻醉学 儿科麻醉学
- 睡眠医学 睡眠医学
背景情况:
- 肥胖症是儿童群体日益关注的一个问题.
- 桃体切除术是儿童常见的一种手术手术.
- 桃体切除术后不良呼吸道事件 (ARE) 是潜在的风险,特别是在肥胖儿童中.
研究的目的:
- 在接受桃体切除手术的肥胖儿童中,调查身体质量指数 (BMI) 对外科手术前呼吸系统不良事件 (ARE) 的预测值.
- 在这个患者群体中确定其他潜在的AREs预测因子.
主要方法:
- 在一个单一的学术耳鼻喉科实践中进行了一系列病例和图表审查.
- 包括3-12岁的BMI≥95百分位数的患者,他们在2011年3月至2020年7月期间接受了桃体切除术.
- 需要独立入院的并发症患者被排除在外. 被定义为术后脱 (SpO2 <90%),输管,CPAP或超过2小时的补充氧气.
主要成果:
- 18名患者 (8%) 经历了至少一次ARE.
- 没有5岁及以上的儿童,BMI在95至98.9百分位之间,有早期AREs.
- 手术前多睡眠图 (PSG) 的指标,包括阻塞性呼吸暂停-呼吸暂停指数 (oAHI) 和氧和度 (SpO2) 极点,在患有和没有ARE的患者之间有显著差异 (P=.02和P=.05,分别). 体重指数z-score在两组之间没有显著差异 (P=.09).
结论:
- 需要住院治疗的不良呼吸道事件在桃体切除术后的肥胖儿童中不常见.
- 身体质量指数 (BMI) 是AREs的一个糟糕的预测指标,除了极端值.
- 在PSG上,较高的oAHI和较低的SpO2底是ARE风险的重要指标,指导术后入院决策. 一些肥胖的儿科桃体切除术患者可能是同一天出院的候选人.
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