多种药物诱导的睡眠内镜在儿科阻塞性睡眠呼吸暂停:阻塞模式和结果
Daniel R S Habib1,2, Liliana Arida-Moody1,2, Ankita Patro1,3
1Surgical Outcomes Center for Kids (SOCKs), Vanderbilt University Medical Center, Nashville, TN, USA.
The Annals of otology, rhinology, and laryngology
|October 23, 2025
概括
儿科阻塞性睡眠呼吸暂停 (OSA) 通常涉及多层次的呼吸道阻塞,特别是在肥胖儿童中. 虽然通过药物诱导睡眠内镜 (DISE) 引导的单一手术改善了结果,但多重手术显示收益正在下降.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 睡眠医学 睡眠医学
- 手术结果研究研究.
背景情况:
- 在腺切除术 (AT) 后,残留阻塞性睡眠呼吸暂停 (OSA) 在儿科患者中很常见,特别是那些肥胖患者.
- 药物诱导睡眠内镜 (DISE) 对于识别上呼吸道阻塞和指导手术干预至关重要.
- 关于儿童OSA多种DISE导向治疗的有效性存在一个知识差距.
研究的目的:
- 评估儿童OSA多个DISE指导程序的结果.
- 分析这些患者的阻塞模式和身体质量指数 (BMI) 的影响.
- 为了比较单个与多个DISE指导干预的疗效.
主要方法:
- 对接受DISE导向干预的儿科患者进行回顾性队列研究 (2009-2020年).
- 收集了关于患者人口统计,DISE时间,阻塞模式,阻塞性呼吸暂停-呼吸暂停指数 (OAHI) 和OSA-18生活质量 (QOL) 评分的数据.
- 使用奇平方和未配对的t测试来比较单个和多个DISE组之间的结果,以及高与正常BMI组之间的结果.
主要成果:
- 122名儿童中有22%接受了多次DISE手术,年龄较小和BMI较高与多次干预有关.
- 在第二次DISE中常见的阻塞包括表腔 (74%),腺体 (67%) 和下层轮 (56%).
- 单个DISE干预显著改善了OAHI和OSA-18分数,而多个程序显示了非显著的改善.
结论:
- 儿科OSA经常表现为持续的多层次阻塞,特别是在年轻的高BMI患者中,需要多次DISE手术.
- 建议对高风险儿科OSA患者进行以解剖学为导向的,针对患者的手术规划.
- 虽然单一的DISE导向干预提供了显著的好处,但重复程序的实用性需要仔细考虑时间和潜在的回报.
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