在患有阻塞性睡眠呼吸暂停的儿童中同步呼吸道损伤
Charlyn N Gomez1, Jane Y Tong1, Nicholas Randolph1
1Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Sleep medicine
|November 25, 2025
概括
同步呼吸道病变在患有阻塞性睡眠呼吸暂停 (OSA) 的儿童中很常见,但不会影响疾病的严重程度或治疗决策. 这表明,在儿科OSA中,对微鼻镜和支气管镜 (MLB) 进行选择性治疗是有必要的.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 睡眠医学 睡眠医学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 药物诱导睡眠内镜是儿科阻塞性睡眠呼吸暂停 (OSA) 上呼吸道评估的标准.
- 通过微鼻镜和支气管镜 (MLB) 评估下呼吸道在儿科OSA中的作用仍然不清楚.
研究的目的:
- 调查在接受腺切除术 (AT) 的儿童中在MLB和OSA严重性期间发现的同步气道病变之间的关联.
主要方法:
- 对117名为OSA接受AT的儿童进行了回顾性队列研究.
- 儿童耳鼻喉科医生审查了MLB的发现.
- 排除标准包括面异常,遗传综合征或气管切除术依赖性.
- 分析将呼吸道发现与人口统计学,多睡眠学和手术管理相关联.
主要成果:
- 在37.6%的儿童中发现了同步的气道病变,最常见的是喉相关的异常 (19.7%).
- 气道病变与喘有关 (P=0.02),但与年龄,种族,保险或早产无关.
- 根据MLB发现,没有患者需要进行干预,手术管理保持不变.
- 两组之间没有观察到多睡眠学参数 (呼吸暂停-呼吸暂停指数,氧和度最低点,睡眠效率) 的显著差异.
结论:
- 同步呼吸道病变经常在儿科OSA患者中发现,但与OSA严重程度无关.
- 这些病变似乎是偶然的,这表明目前的MLB使用可能过度指示.
- 在等待基于证据的指导方针之前,建议在儿科OSA中采用个性化,选择性的MLB方法.
相关概念视频
Sleep Apnea
456
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
456
Other Pulmonary Disorders
1.5K
Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.
1.5K
Chronic Obstructive Pulmonary Disease-II: Pathophysiology
4.2K
Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation
Chronic Inflammation
4.2K
Cardiopulmonary Resuscitation II: ACLS Airway Management
502
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
502
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
3.1K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
3.1K
Pulmonary Hypertension: Classification and Pathogenesis
547
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
547


