Insights into Selected Aspects of Pediatric Sleep Medicine.
Insights into Selected Aspects of Pediatric Sleep Medicine.
复制标题
深入了解儿科睡眠医学的某些方面。
DOI：
10.1164/rccm.201502-0279rr
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发表时间：
2015
影响因子：
24.7
通讯作者：
Lapping-Carr,Gabrielle
中科院分区：
文献类型：
--
作者：
Gileles-Hillel,Alex;Philby,MonaF;Lapping-Carr,Gabrielle
健康相关生活质量（QoL）评估是评价手术和其他干预措施的有用工具。生活质量结果也决定了决策者的决策，并影响患者的满意度。阻塞性睡眠呼吸暂停（OSA）是儿童的常见疾病，与总体健康相关的QoL（青少年特发性关节炎儿童的评分）显著降低以及疾病特异性QoL降低相关（2）。以前的观察性研究表明，腺样体扁桃体切除术（AT），作为儿童OSA的一线治疗，可改善生活质量，但这些研究因未纳入对照组而受到阻碍为了更严格地解决这个问题，Garetz及其同事（1）分析了儿童腺样体扁桃体切除术试验（CHAT）的数据，CHAT是一项随机，多中心临床试验。从6个中心共招募了453名5至9.9岁的轻度至中度OSA儿童，并将其随机分配至OSA诊断后1个月内的早期AT（eAT）或观察等待（WWSC）。使用儿科生活质量（PedsQL）量表（包括身体、情感、社会和学术领域）评估了一般健康相关的QoL，并使用OSA-18工具评估了疾病特异性QoL，观察了五个不同的领域：睡眠障碍、身体痛苦、情绪困扰、日间问题和护理人员问题（1）。此外，OSA的严重程度在儿科睡眠问卷（PSQ）的睡眠相关呼吸障碍（SRDB）量表上进行排名。
Health-related quality of life (QoL) assessments are a useful tool for evaluation of surgical and other interventions. QoL outcomes also dictate policy makers’ decision-making and affect patient satisfaction. Obstructive sleep apnea (OSA) is a common condition in children and is associated with significantly reduced general health-related QoL (scores in the range of children with juvenile idiopathic arthritis) as well as reduced disease-specific QoL (2). Previous observational studies suggested that adenotonsillectomy (AT), the first-line treatment for pediatric OSA, results in improvements of QoL, but these studies have been hampered by not including a control group (ie, a no-surgery group) and by lack of randomization (3).To address this question more rigorously, Garetz and colleagues (1) analyzed data from the Childhood Adenotonsillectomy Trial (CHAT), a randomized, multicenter clinical trial. A total of 453 children, 5 to 9.9 years of age, with mild to moderate OSA were recruited from six centers and were randomly assigned to early AT (eAT) within 1 month of OSA diagnosis or to watchful waiting (WWSC). Generic health-related QoL was evaluated with the Pediatric Quality of Life (PedsQL) inventory comprising physical, emotional, social, and academic domains, and disease-specific QoL was assessed with the OSA-18 instrument, looking at five different domains: sleep disturbance, physical suffering, emotional distress, daytime problems, and caregiver concerns (1). In addition, OSA severity was ranked on a Sleep-Related Breathing Disorder (SRDB) scale of the Pediatric Sleep Questionnaire (PSQ).