A DIAGNOSTIC-APPROACH TO SUSPECTED OBSTRUCTIVE SLEEP-APNEA IN CHILDREN
A DIAGNOSTIC-APPROACH TO SUSPECTED OBSTRUCTIVE SLEEP-APNEA IN CHILDREN
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DOI：
10.1016/s0022-3476(84)80348-0
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发表时间：
1984-01-01
影响因子：
5.1
通讯作者：
HUNT, C
中科院分区：
文献类型：
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作者：
BROUILETTE, R;HANSON, D;HUNT, C
大多数患有阻塞性睡眠呼吸暂停[OSA]的儿童将受益于扁桃体切除术和腺样体切除术。虽然多导监测仍然是明确的诊断技术，儿童怀疑有阻塞性睡眠呼吸暂停可能不需要这样的评价。一个标准化的问卷调查，23名儿童的父母与多导证实OSA相关的腺样体扁桃体肥大，46名年龄和性别匹配的正常儿童和23名儿童随后提到，因为可能的OSA。与对照组相比，OSA组中以下症状的发生率显著增加：睡眠期间呼吸困难，96 vs. 2%;父母观察到的呼吸暂停，78 vs. 5%;打鼾，96 vs. 9%;睡眠不安，78 vs. 23%;慢性溢液，61 vs. 11%;清醒时用嘴呼吸，87 vs. 18%。使用判别分析，OSA评分得出，正确分类所有对照组和23例OSA患者的22。综合所有组的数据，发现OSA评分> 3.5对需要行腺样体切除术的OSA具有高度预测性; OSA评分< -1的儿童没有OSA; OSA评分在-1到3.5之间的儿童需要进行多导监测，以确定睡眠相关气道阻塞的严重程度和是否需要手术治疗。OSA评分的使用可以减少对多导监测的需要，并有助于选择儿童进行扁桃体切除术和腺样体切除术。
Most children with obstructive sleep apnea [OSA] will benefit from tonsillectomy and adenoidectomy. Although polygraphic monitoring remains the definitive diagnostic technique, children suspected of having OSA may not require such evaluation. A standardized questionnaire was given to the parents of 23 children with polygraphically proved OSA related to adenotonsillar hypertrophy, 46 age- and sex-matched normal children and 23 children subsequently referred because of possible OSA. Significantly increased frequencies of the following symptoms were found in the OSA group compared with the control group: difficulty breathing during sleep, 96 vs. 2%; apnea observed by the parents, 78 vs. 5%; snoring, 96 vs. 9%; restless sleep, 78 vs. 23%; chronic rhinorrhea, 61 vs. 11%; and mouth breathing when awake, 87 vs. 18%. Using discriminant analysis, an OSA score was derived that correctly classified all control subjects and 22 of 23 patients with OSA. Considering the data from all groups, it was found that OSA scores > 3.5 were highly predictive of OSA requiring adenotonsillectomy; no child with an OSA score < -1 had OSA; and in children with OSA scores between -1 and 3.5, polygraphic monitoring was required to determine the severity of sleep-related airway obstruction and the need for surgical treatment. Use of the OSA score should decrease the need for polygraphic monitoring and facilitate selection of children for tonsillectomy and adenoidectomy.