重视阻塞性睡眠呼吸暂停低通气综合征儿童腺样体

儿童阻塞性睡眠呼吸暂停低通气综合征(OSAS)是常见的儿童睡眠呼吸疾病。OSAS对儿童体格、神经认知发育、心血管系统以及内分泌代谢水平都可能产生危害。腺样体、扁桃体肥大是儿童OSAS的主要病因,腺样体、扁桃体切除术(T&A)因而是治疗儿童OSAS的一线治疗方法。多数接受T&A治疗的儿童睡眠呼吸障碍有显著改善,但按照研究定义的不同,儿童T&A术后OSAS残留的发生率在21.6%~49.0%之间。一些儿童存在术后OSAS残留的危险因素,对这些患儿后续的监测和管理有助于纠正残留疾病导致的病理生理危害及并发症。就腺样体、扁桃体切除术后残留的危险因素以及后续检查、治疗做一综述,旨在加强对儿童OSAS术后随访和管理的重视,提高儿童睡眠疾病的整体诊断和治疗水平。

Post-surgery management in children with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome(OSAS)is a common pediatric sleep-respiratory disorder. OSAS can cause impairments in childrens physical and neurocognitive development, cardiovascular systems, endocrine systems, and metabolic status. Adenoidal or tonsillar hypertrophy are the most common causes of pediatric OSAS. Adenotonsillectomy(T&A)is therefore the first-line treatment for children with OSAS. Although most children show significant improvement after T&A, the incidence of residual disease is between 21.6% and 49%, depending on the definition of residual disease and the presence or absence of risk factors for OSAS. Follow-up and management of residual OSAS is beneficial to avoid disease-related complications. This paper summarizes the potential risk factors for residual OSAS and useful follow-up strategies after adenotonsillectomy in children, and aims to improve the diagnosis and management of pediatric sleep-disordered breathing.