在腺切除术后肥胖儿科患者中阻断性睡眠呼吸暂停的复发:系统性审查
Adi Cohen1, Andrew Gunthner1, Adam Cervone1
1Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.
Cureus
|June 24, 2025
概括
阻塞性睡眠呼吸暂停 (OSA) 在腺切除术 (AT) 后经常在肥胖儿童中复发. 肥胖是残留疾病的重要风险因素,表明单独的AT往往不足以解决.
科学领域:
- 儿科肺病学 儿科肺病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 肥胖医学 肥胖医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是儿科肥胖的一个常见并发症.
- 腺切除术 (AT) 是小儿OSA的主要手术治疗方法.
- 肥胖儿童中AT后OSA的复发引起了对治疗疗效的担忧.
研究的目的:
- 系统地审查在AT后肥胖儿科患者中OSA的复发情况.
- 为了确定与该人群中AT后残留OSA相关的关键风险因素.
主要方法:
- 在 Embase,PubMed 和 Web of Science 的系统文献搜索.
- 包括过去五年关于儿科患者 (<18岁) 的同行评审文章,BMI≥95百分位,在手术前诊断出OSA/睡眠呼吸障碍,并接受了AT.
- 分析了11项符合条件的研究.
主要成果:
- 82%的研究表明,在AT后,肥胖和OSA复发之间存在显著的联系.
- 较高的基线呼吸暂停-呼吸暂停指数,术后体重增加和剩余上呼吸道阻塞是关键风险因素.
- 两项研究显示出相互矛盾的结果,但存在局限性.
结论:
- 单独的腺切除术往往不足以解决肥胖儿科患者的OSA.
- 高复发率需要多学科的方法,包括体重管理和非侵入性通风.
- 改善结果需要为这个弱势群体制定综合护理策略.
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