A REVIEW OF 50 CHILDREN WITH OBSTRUCTIVE SLEEP-APNEA SYNDROME
A REVIEW OF 50 CHILDREN WITH OBSTRUCTIVE SLEEP-APNEA SYNDROME
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作者：
GUILLEMINAULT, C;KOROBKIN, R;WINKLE, R
对患有阻塞性睡眠呼吸暂停综合征和睡眠期间相关呼吸障碍的儿童和青少年 (50) 进行了回顾。根据受试者的呼吸不规律是继发于医疗问题（第 1 组）还是主要主诉（第 2 组），对受试者进行细分。最常见的主诉是白天过度嗜睡。多动症和反社会行为也经常被提及。据报道，20% 的病例出现了显着的性格变化。临床症状包括发育迟缓、年龄体重异常、急性心脏或心肺衰竭、高血压和频繁的上呼吸道感染。所有病例均报告有持续、严重的打鼾；夜间睡眠中断、梦游、噩梦和遗尿很常见。所有受试者和 22 名对照患者在睡眠期间接受至少 1 晚的多描记监测。报告人群的夜间睡眠受到严重干扰。 86% 的病例中，第 3 阶段 NREM（非快速眼动）睡眠完全消失； REM（快速眼动）睡眠减少较少。对这些案件的管理进行了审查。八名患者接受了永久性气管切开术。 30 名儿童接受了扁桃体切除术和/或腺样体切除术（3 名后来需要气管切开术）。还使用了非手术方法，特别是在第 1 组中。介绍了迄今为止对这些病例的后续情况。
Children and adolescents (50) with obstructive sleep apnea syndrome and related breathing disorders during sleep are reviewed. Subjects were subdivided according to whether their breathing irrgularity was secondary to a medical problem (group 1) or was the primary complaint (group 2). The most common presenting complaint was excessive daytime somnolence; hyperactivity and antisocial behavior also were cited frequently. In 20% of cases, substantial personality changes were reported. Clinical symptoms included failure to thrive, abnormal weight for age, acute cardiac or cardiorespiratory failure, hypertension, and frequent upper airway infections. Continuous, heavy snoring was reported in all cases; disrupted nocturnal sleep, sleep walking, nightmares and enuresis were common. All subjects, and 22 control patients, were monitored polygraphically during sleep for at least 1 night. Nocturnal sleep in the reported population was severely disrupted. A complete disappearance of stage 3 NREM (non-rapid eye movement) sleep was noted in 86% of cases; REM (rapid eye movement) sleep was decreased less. The management of these cases is reviewed. Eight patients received permanent tracheostomies. Thirty children had tonsillectomy and/or adenoidectomy (3 later required tracheostomy). Non-surgical approaches also were used, particularly in group 1. Follow-up on these cases to date is presented.