儿童OSA腺样体扁桃体术后症状残留的危险因素分析
Analysis of Risk Factors for Residual Symptoms After Adenotonsillectomy in Children with OSA
DOI: 10.12677/acm.2025.15123525, PDF,   
作者: 李 欢, 姚红兵*：重庆医科大学附属儿童医院耳鼻咽喉头颈外科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，重庆市卫生健康委儿童重要器官发育与疾病重点实验室，重庆
关键词: 阻塞性睡眠呼吸暂停；儿童；腺样体扁桃体切除术；危险因素；Obstructive Sleep Apnea； Child； Adenotonsillectomy； Risk Factors
摘要: 目的：系统分析儿童阻塞性睡眠呼吸暂停(OSA)行腺样体扁桃体切除术后症状残留的危险因素，为临床防治提供依据。方法：检索国内外相关文献，从术前疾病严重程度、肥胖、遗传综合征及合并症等方面对POSA的危险因素进行归纳与综述。结果：术前中重度OSA、肥胖(>95th)及遗传综合征(如唐氏综合征)是POSA的明确独立危险因素。肥胖患儿术后残留风险是非肥胖患儿的3.47倍(RR = 3.47, 95%CI: 2.04~5.92)。合并哮喘与变应性鼻炎与POSA的关联目前尚存争议。结论：术前准确识别高风险患儿至关重要，对于存在明确危险因素的患儿，应加强围术期评估与管理，并探索多学科协作的个体化治疗策略以改善预后。
Abstract: Objective: To systematically analyze the risk factors for residual symptoms following adenotonsillectomy in children with obstructive sleep apnea (OSA), thereby providing evidence for clinical prevention and management. Methods: Relevant literature was retrieved and reviewed to summarize the risk factors for persistent OSA (POSA) from aspects of preoperative disease severity, obesity, genetic syndromes, and comorbidities. Results: Preoperative moderate-to-severe OSA, obesity (>95th percentile), and genetic syndromes (e.g., Down syndrome) were identified as independent risk factors for POSA. The risk of residual OSA in obese children was 3.47 times higher than that in non-obese children (RR = 3.47, 95%CI: 2.04~5.92). The associations between comorbidities (asthma and allergic rhinitis) and POSA remain controversial. Conclusion: Preoperative identification of high-risk children is crucial. For children with established risk factors, perioperative assessment and management should be strengthened, and multidisciplinary collaborative individualized treatment strategies should be explored to improve prognosis.
文章引用：李欢, 姚红兵. 儿童OSA腺样体扁桃体术后症状残留的危险因素分析[J]. 临床医学进展, 2025, 15(12): 1245-1252. https://doi.org/10.12677/acm.2025.15123525

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