Adenotonsillectomy for obstructive sleep apnea in obese children
Adenotonsillectomy for obstructive sleep apnea in obese children
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DOI：
10.1016/j.otohns.2004.02.024
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发表时间：
2004-07-01
影响因子：
3.4
通讯作者：
Kelly, J
中科院分区：
文献类型：
--
作者：
Mitchell, RB;Kelly, J
目标。为了研究阻塞性睡眠呼吸暂停患者行扁桃体切除术后肥胖儿童的睡眠行为和生活质量的变化。研究设计和地点：新墨西哥大学儿童医院的前瞻性研究。方法：符合纳入标准且呼吸窘迫指数(RDI)大于5的儿童纳入研究并行腺扁桃体切除术。所有儿童在手术前和术后都接受了全夜多导睡眠监测。在多导睡眠监测时记录年龄和性别特定百分位数的BMI。照顾者被要求在多导睡眠监测之前完成OSA-18生活质量调查，并在手术后6个月内进行第二次调查。用配对学生t检验比较手术前后多导睡眠图和OSA-18调查的得分。结果：研究人群包括30名儿童。26名儿童(86%)是男性。纳入研究时，这些儿童的平均年龄为9.3岁；范围从3.0岁到17.2岁。术前BMI平均值为28.6(19.2~47)。术后平均体重指数为27.9(17.8~27.9)。经双尾配对t检验，差异无统计学意义(P=0.06)。术前平均RDI值为30.0，术后RDI值为11.6(P<；0.001)。结论：单纯性阻塞性睡眠呼吸暂停低通气综合征患儿行腺扁桃体切除术后，患者的呼吸紊乱指数和生活质量均有明显改善，而体重指数无明显变化。然而，在大多数儿童中，阻塞性睡眠呼吸暂停不能解决。
OBJECTIVE. To study changes in sleep behavior and quality of life in obese children after adenotonsillectomy for obstructive sleep apnea.STUDY DESIGN AND SETTING: Prospective study at the University of New Mexico Children's Hospital.METHODS. Children who met inclusion criteria and had a respiratory distress index (RDI) greater than 5 were enrolled in the study and underwent adenotonsillectomy. All children underwent preoperative and postoperative full-night polysomnography. Age- and gender-specific percentile BMI was recorded at the time of polysomnography. Caregivers were asked to complete an OSA-18 quality of life survey prior to polysomnography and a second survey within 6 months of surgery. Scores from preoperative and postoperative polysomnography and OSA-18 surveys were compared using the paired Student's t test.RESULTS: The study population included 30 children. Twenty-six children (86%) were male. The mean age of the children at the time of inclusion in the study was 9.3 years; range, 3.0 to 17.2. The mean preoperative BMI was 28.6 (range, 19.2 to 47. 1) and the mean postoperative BMI was 27.9 (range, 17.8 to 27.9). A 2-tailed paired t test showed that this difference is not statistically significant (P = 0.06). The mean preoperative RDI was 30.0 and the mean postoperative RDI was 11.6 (P < 0.001). The preoperative mean total OSA- 18 score was 78.2 and the postoperative mean total score was 39.8 (P < 0.001).CONCLUSION: Obese children with OSA who undergo adenotonsillectomy show a marked improvement in RDI and in quality of life with no change in BMI. However, in the majority of children, OSA does not resolve.