目的 探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的鼻腔通气功能的评价及与生活质量相关性分析。方法 对50例OSAHS拟行腺样体、扁桃体切除手术的患儿,给予术前多导睡眠监测(PSG)检查,分别于术前和术后2周进行鼻声反射检查、OSA-18量表问卷调查,对手术前后的结果进行比较,并对OSA-18量表与腺样体肥大程度相关性进行分析。结果 OSAHS患儿术后2周鼻声反射与术前比较,鼻咽腔容积(NPV)、最小鼻腔横截面积(MCSA)增大,最小鼻腔横截面积至前鼻孔的距离(DCAN)前移,差异有统计学意义(P＜0.05)。不同腺样体分度间术前OSA-18量表总评分差异无统计学意义(F=0.543,P=0.58)。术前和术后2周的OSA-18量表中睡眠障碍、身体症状、情绪不佳、白天功能状态、患儿监护人的影响程度各个维度,以及总评分差异均具有统计学意义(P＜0.05)。结论 腺样体、扁桃体切除术可有效改善OSAHS患儿主观症状和鼻通气功能。OSA-18量表可反映患儿主观症状,鼻声反射检查对于OSAHS的诊断、治疗方案的选择及手术疗效的评估有着重要的临床价值。
Abstract
Objective To investigate the evaluation of nasal ventilation function in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with quality of life. Methods Preoperative polysomnography (PSG) examination was given to 50 children with obstructive sleep apnea-hypopnea syndrome (OSAHS) who were scheduled to undergo adenoid and tonsil removal surgery,and nasal acoustic reflex examination and OSA-18 scale questionnaire survey were conducted before and 2 weeks after the operation. The results before and after the operation were compared, and the correlation between the OSA-18 scale and the degree of adenoid hypertrophy was analyzed. Results Compared with the preoperative nasal acoustic reflex, the nasopharyngeal volume (NPV) and the minimum nasal cross-sectional area (MCSA) increased, and the distance from the minimum nasal cross-sectional area to the anterior nasal aperture (DCAN) shifted forward in the 2 weeks after the surgery, with statistically significant differences (P＜0.05). There was no statistically significant difference in the total score of the OSA-18 scale among different adenoid degrees before and after the surgery (F = 0.543, P = 0.58). In the OSA-18 scale before and 2 weeks after the surgery, there were statistically significant differences in the dimensions of sleep disorders, physical symptoms, poor mood, daytime functional status, the impact on the guardians of the children,and the total score (P＜0.05). Conclusions Adenoid and tonsil removal surgery can effectively improve the subjective symptoms and nasal ventilation function of children with OSAS. The OSA-18 scale can reflect the subjective symptoms of children. The examination of nasal acoustic reflex has important clinical value for the diagnosis, the selection of treatment plans and the evaluation of surgical efficacy of OSAHS.
关键词
鼻通气功能 /
鼻测量 /
声学,阻塞性睡眠呼吸暂停低通气综合征 /
儿童
Key words
nasal ventilation function /
rhinometry /
acoustics,obstructive sleep apnea-hypopnea syndrome /
children
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