在儿童睡眠呼吸障碍中,跨合并性群体和手术状态的DISE发现
Elise Krippaehne1, Andrea Hildebrand2, Thuan Nguyen2
1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
The Laryngoscope
|December 5, 2025
概括
药物诱导睡眠内镜 (DISE) 在儿科阻塞性睡眠呼吸暂停 (OSA) 中显示了多种呼吸道阻塞. 根据手术史和伴随性疾病 (如唐氏综合征) 的不同,研究结果有所不同,这会影响睡眠呼吸障碍 (SDB) 的治疗策略.
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:
- 阻塞性睡眠呼吸暂停 (OSA) 和睡眠呼吸障碍 (SDB) 是重要的儿科健康问题.
- 药物诱导睡眠内镜 (DISE) 越来越多地用于评估儿科OSA/SDB,特别是在复杂的病例中.
- 了解上呼吸道阻塞模式对于有效管理至关重要.
研究的目的:
- 描述DISE在患有OSA/SDB的儿科患者中发现的解剖阻塞模式.
- 为了比较手术前的儿童和经过腺切除术 (T&A) 的儿童之间的DISE发现.
- 分析伴随性疾病,特别是唐氏综合征和超重/肥胖症对DISE发现的影响.
主要方法:
- 在主要数据库 (PubMed/MEDLINE,Cochrane图书馆,EMBASE) 进行了系统的文献搜索,直到2024年9月.
- 选择了符合严格纳入标准的研究,涉及1415名儿科患者.
- 数据分析包括使用R软件生成的森林地块,以综合发现.
主要成果:
- 经过T&A后的患者表现出腺体和侧壁/桃体阻塞的减少,但通常需要修复手术 (56.4%).
- 在T&A后的儿童中,舌头底部阻塞更为频繁,特别是那些患有唐氏综合征或没有并发症的儿童.
- 多部位阻塞有所不同,在未经手术治疗的唐氏综合征患者和没有并发症的T&A后患者中最高.
结论:
- DISE强调了小儿OSA/SDB的气道阻塞模式的显著变化.
- 这些模式受到手术状态和伴随疾病的存在的影响,如唐氏综合征和肥胖.
- DISE的发现强调了儿科OSA/SDB的复杂性,并为个性化治疗方法提供了信息.
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