儿科阻塞性睡眠障碍 呼吸:在腺切除术后心血管变化
Francisco Alves de Sousa1,2, Marta Rios3, Paula Branco1
1Otorhinolaryngology and Head & Neck surgery, Unidade Local de Saúde de Santo António, Porto, Portugal.
概括
腺切除术显著降低了睡眠阻断性呼吸障碍 (OSDB) 和腺细胞缩 (ATH) 的儿童的心率和心脏输出. 年龄较小的孩子在手术后心脏输出下降的程度更为明显.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 睡眠医学 睡眠医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 阻塞性睡眠呼吸障碍 (OSDB) 在儿童中很常见,经常与腺突增大 (ATH) 相关.
- 腺切除术是ATH儿童OSDB的主要治疗方法.
研究的目的:
- 预期评估腺切除术在患有ATH和OSDB的儿童的心血管影响.
- 用先进的统计方法分析心率,血压和心脏输出量的变化.
主要方法:
- 90名患有ATH和临床OSDB的儿童 (4-14岁) 接受腺切除术的前性研究.
- 术前和术后测量静止心率,血压和估计心脏输出.
- 一般化估计方程 (GEE) 模型用于分析心血管参数变化,考虑重复测量和混因素.
主要成果:
- 腺切除术导致静止心率 (p=0.028) 和估计心率 (p=0.003) 的显著降低.
- 没有观察到系统性或透气性血压的显著变化 (p>0.05).
- 估计心脏输出量和年龄的变化之间存在显著的负相关性 (p<0.001),年轻儿童的减少更大.
结论:
- 在患有ATH和OSDB的儿童中,腺切除术可以显著改变心血管参数,特别是心率和心脏输出.
- 这些发现表明,由于上呼吸道阻塞的缓解,手术后的休息交感活动可能会下降.
- 年龄似乎是影响心血管反应的一个因素,在这个儿科群体的腺切除术.
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