肥胖儿童阻塞性睡眠呼吸暂停综合征的诊治进展
Obesity as a Risk Factor for Pediatric Obstructive Sleep Apnea: A Review
DOI: 10.12677/ACRP.2017.53003, PDF, HTML, XML, 下载: 1,744  浏览: 3,852 
作者: 程涵蓉：暨南大学第二临床医学院，广东省深圳市人民医院儿科，广东 深圳；李栋才：深圳龙岗耳鼻喉专科医院，广东 深圳；Macario Camacho ：斯坦福大学医学院，精神病学系，睡眠医学系，美国 红木市(加州)；Tripler AMC，耳鼻喉科头颈外科，Tripler军医医疗中心，美国 檀香山市(夏威夷州) ；Peter J.Koltai：斯坦福大学Lucile Packard儿童医院系，小儿耳鼻喉科，斯坦福大学斯坦福大学医学院耳鼻咽喉头颈外科，美国 加州
关键词: 儿童；肥胖；睡眠呼吸暂停；诊断；治疗；Children； Obesity； Sleep Apnea； Diagnosis； Therapies
摘要: 近年来，肥胖已经成为儿童中的常见病。肥胖儿童阻塞性睡眠呼吸暂停综合征(OSAS)的发病率较高。本综述的目的是评估OSAS肥胖儿童的危险因素，并讨论诊断和治疗的最新进展。对文献的回顾表明儿科OSAS的诊断存在不足。最佳治疗策略应同时针对OSAS和肥胖。治疗方案包括行为改变、气道正压(PAP)装置和手术。手术的成功率存在个体差异，并且有手术后体重增加的风险。对于有手术失败的儿童，可以使用睡眠内窥镜检查进一步评估阻塞的区域，从而确定手术方案。减肥可作为一线治疗选择的替代方案，这需要基于家庭的行为干预。儿科医生应该意识到其在肥胖儿童中的流行率增加，并对肥胖患儿进行OSAS的筛查。
Abstract: In recent years, obesity has increasingly become a common disorder among children. Obese children can have a higher prevalence of obstructive sleep apnea syndrome (OSAS). The objective of this review is to assess the risk factors of obese children with OSAS and discuss the updated information for diagnosis and treatment. A review of the literature demonstrates that there is an under-diagnosis of pediatric OSAS. An optimal treatment strategy should target OSAS and obesity simultaneously. Treatment options include behavior modifications, positive airway pressure (PAP) devices and surgery. The success of surgery is highly variable and there is a risk of a postoperative weight gain. For children who have failed surgeries, sleep endoscopy can be used to further assess the areas of obstruction and thus target subsequent surgeries. Weight loss may also be an alternative as first-line treatment option and would require family-based behavioral interventions. Pediatricians should be aware of its increased prevalence in obese children and screen for it.
文章引用：程涵蓉, 李栋才, MacarioCamacho, Peter J.Koltai. 肥胖儿童阻塞性睡眠呼吸暂停综合征的诊治进展[J]. 亚洲儿科病例研究, 2017, 5(3): 11-18. https://doi.org/10.12677/ACRP.2017.53003

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