儿童阻塞型睡眠呼吸暂停低通气综合征诊断及治疗的研究进展
Overview on Diagnosis and Treatment of Obstructive Sleep Apnea-Hypopnea Syndrome in Children
DOI: 10.12677/ACM.2021.116375, PDF,   
作者: 张雅丽：内蒙古医科大学附属医院耳鼻咽喉科，内蒙古 呼和浩特；内蒙古自治区妇幼保健院|妇产医院|儿童医院耳鼻喉科，内蒙古 呼和浩特；崔晓波：内蒙古医科大学附属医院耳鼻咽喉科，内蒙古 呼和浩特
关键词: 阻塞性睡眠呼吸暂停低通气综合征(OSAHS)；儿童；腺样体；Obstructive Sleep Apnea-Hypopnea Syndrome； Children； Adenoid
摘要: 阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)主要是由于睡眠时上气道部分或完全阻塞扰乱正常通气而出现呼吸暂停或低通气，是一类较为常见的疾病。儿童腺样体/扁桃体增生肥大导致的上气道狭窄是儿童阻塞性睡眠呼吸暂停综合征的主要原因，诊断主要依据主观症状、X线、电子鼻咽镜和睡眠监测等检查。对于儿童OSAHS的治疗方式多样，以手术治疗和药物治疗较为常见。本文将对目前儿童OSAHS的多种诊断及治疗方法的研究进展作一综述。
Abstract: Obstructive sleep apnea-hypopnea syndrome (OSASH) in children is partial upper airway obstruction and/or complete upper airway obstruction leading to disrupt ventilation result in hypopnea and/or apnea during sleep. OSAHS is a common illness. Upper airway stenosis caused by adenoid/tonsil hyperplasia in children is the main cause of obstructive sleep apnea syndrome in children. The diagnosis is mainly based on subjective symptoms, X-ray, electronic nasopharyngoscopy and polysomnography. There are various treatment methods for children OSAHS, and surgical treatment and drug treatment are more common. This article will review the research progress of multiple diagnosis and treatment methods of OSAHS in children.
文章引用：张雅丽, 崔晓波. 儿童阻塞型睡眠呼吸暂停低通气综合征诊断及治疗的研究进展[J]. 临床医学进展, 2021, 11(6): 2596-2602. https://doi.org/10.12677/ACM.2021.116375

参考文献

[1] Marcus, C.L., Brooks, L.J., Draper, K.A., et al. (2012) Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics, 130, e714-e755. [Google Scholar] [CrossRef] [PubMed]
[2] Lumeng, J.C. and Chervin, R.D. (2008) Epidemiology of Pediatric Obstructive Sleep Apnea. Proceedings of the American Thoracic Society, 5, 242-252. [Google Scholar] [CrossRef] 
[3] Enright, P.L., Goodwin, J.L., Sherrill, D.L., et al. (2003) Blood Pressure Elevation Associated with Sleep-Related Breathing Disorder in a Community Sample of White and Hispanic Children: The Tucson Children’s Assessment of Sleep Apnea Study. Archives of Pediatrics & Adolescent Medicine, 157, 901-904. [Google Scholar] [CrossRef] [PubMed]
[4] Kohyama, J., Ohinata, J.S. and Hasegawa, T. (2003) Blood Pressure in Sleep Disordered Breathing. Archives of Disease in Childhood, 88, 139-142. [Google Scholar] [CrossRef] [PubMed]
[5] Leung, L.C.K., Ng, D.K., Lau, M.W., et al. (2006) Twenty-Four-Hour Ambulatory BP in Snoring Children with Obstructive Sleep Apnea Syndrome. Chest, 130, 1009-1017. [Google Scholar] [CrossRef] 
[6] Li, A.M., Au, C.T., Sung, R.Y., et al. (2008) Ambulatory Blood Pressure in Children with Obstructive Sleep Apnoea: A Community Based Study. Thorax, 63, 803-809. [Google Scholar] [CrossRef] [PubMed]
[7] Marcus, C. and Greene, M.J. (1998) Blood Pressure in Children with Obstructive Sleep Apnea. American Journal of Respiratory & Critical Care Medicine, 157, 1098-1103. [Google Scholar] [CrossRef] [PubMed]
[8] Kim, E.J., Choi, J.H., Kim, K.W., et al. (2011) The Impacts of Open Mouth Breathing on Upper Airway Space in Obstructive Sleep Apnea: 3-D MDCT Analysis. European Archives of Oto-Rhino-Laryngology, 268, 533-539. [Google Scholar] [CrossRef] [PubMed]
[9] 中国儿童OSA诊断与治疗指南制订工作组, 中华医学会耳鼻咽喉头颈外科学分会小儿学组, 中华医学会儿科学分会呼吸学组. 中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020) [J]. 中国循证医学杂志, 2020, 20(8): 883-900. [Google Scholar] [CrossRef] 
[10] 洪瞿芳, 陈金春, 张永添. 儿童腺样体肿大鼻咽侧位片3种测量方法比较及与OSAHS的相关性[J]. 现代实用医学, 2015, 27(6): 761-763+837.
[11] 李声云, 顾浩玉, 王颖. 儿童腺样体肥大A/N比值测量与手术对照分析(附134例报告) [J]. 海南医学, 2010, 21(3): 25-27.
[12] 吴恩惠. 中华影像医学: 头颈部卷[M]. 北京: 人民卫生出版社, 2003: 201-203.
[13] 江菊芬, 张雅, 高琦. 儿童腺样体肥大的X线表现[J]. 现代医学, 2005, 14(4): 153.
[14] 陈俊, 彭琲, 谭毅. 儿童腺样体肥大影像学诊断进展[J]. 中国临床新医学, 2012, 5(12): 1190-1194.
[15] 马军. 鼻咽部侧位X线片对儿童腺样体肥大的诊断价值[J]. 现代医院, 2010, 10(8): 62-63.
[16] 袁林秀. 鼻咽侧位X线片在儿童腺样体肥大诊断中的应用价值[J]. 中国实用医刊, 2013, 40(2): 119-120.
[17] 王光明, 李振亚, 邵国庆, 等. 分析X线影像学检查诊断对儿童腺样体肥大的价值[J]. 世界临床医学, 2015, 9(8): 227.
[18] 孙欣, 柳斌, 季文樾. 电子鼻咽镜在儿童腺样体肥大诊断中的应用价值[J]. 中国中西医结合耳鼻咽喉科杂志, 2011, 19(6): 432-433.
[19] 罗东福. 电子鼻咽镜检查在评价腺样体肥大中的临床价值分析[J]. 中国医药指南, 2012, 10(31): 541-542.
[20] 顾衍, 吴国民, 童雷, 等. 电子鼻咽镜检查在评价儿童腺样体肥大中的价值[J]. 现代中西医结合杂志, 2007, 16(9): 1166-1168.
[21] 李敏. 腺样体肥大儿童多导睡眠监测与鼻咽侧位片相关性分析[D]: [硕士学位论文]. 青岛: 青岛大学, 2011.
[22] Marcus, C.L., Moore, R.H., Rosen, C.L., et al. (2013) Childhood Adenotonsillectomy Trial (CHAT): A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea. The New England Journal of Medicine, 368, 2366.
[23] 谢马先. 扁桃体腺样体切除术治疗阻塞性睡眠呼吸暂停综合征疗效研究[J]. 中国医学文摘(耳鼻咽喉科学), 2020, 35(4): 235-237.
[24] 王淑珍, 郭良蓉, 王丹, 段星, 张秀菊, 姚远, 田永胜. 低温等离子射频扁桃体及腺样体切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征的疗效[J]. 中国现代医生, 2019, 57(25): 28-31.
[25] Venekamp, R.P., Hearne, B.J., Chandrasekharan, D., et al. (2015) Tonsillectomy or Adenotonsillectomy versus Non-Surgical Management for Obstructive Sleep-Disordered Breathing in Children. Cochrane Database of Systematic Reviews, 10, CD011165. [Google Scholar] [CrossRef] 
[26] Lee, C.H., Hsu, W.C., Chang, W.H., et al. (2016) Polysomnographic Findings after Adenotonsillectomy for Obstructive Sleep Apnoea in Obese and Non-Obese Children: A Systematic Review and Meta-Analysis. Clinical Otolaryngology, 41, 498-510. [Google Scholar] [CrossRef] [PubMed]
[27] 郭靖晗, 李远远, 刘月华. 儿童阻塞性睡眠呼吸暂停低通气综合征治疗的研究进展[J]. 复旦学报(医学版), 2020, 47(5): 783-788.
[28] Goldbart, A.D., Greenberg-Dotan, S. and Tal, A. (2012) Montelukast for Children with Obstructive Sleep Apnea: A Double-Blind, Placebo-Controlled Study. Pediatrics, 130, e575-e580. [Google Scholar] [CrossRef] [PubMed]
[29] Kheirandish-Gozal, L., Bandla, H.P. and Gozal, D. (2016) Montelukast for Children with Obstructive Sleep Apnea: Results of a Double-Blind, Randomized, Placebo-Controlled Trial. Annals of the American Thoracic Society, 13, 1736-1741. [Google Scholar] [CrossRef] 
[30] Chan, C.C., Au, C.T., Lam, H.S., et al. (2015) Intranasal Corticosteroids for Mild Childhood Obstructive Sleep Apnea—A Randomized, Placebo-Controlled Study. Sleep Medicine, 16, 358-363. [Google Scholar] [CrossRef] [PubMed]
[31] Kheirandish-Gozal, L. and Gozal, D. (2008) Intranasal Budesonide Treatment for Children with Mild Obstructive Sleep Apnea Syndrome. Pediatrics, 122, e149-e155. [Google Scholar] [CrossRef] [PubMed]
[32] 黄选兆. 实用耳鼻咽喉头颈外科学[M]. 第2版. 北京: 人民卫生出版社, 2008: 307-308.
[33] Kari J. Kvaerner, 郑远征. 腺样体切除术在反复上呼吸道感染儿童中的应用即刻手术与观察等待相比似乎并不能带来更多益处[J]. 英国医学杂志(中文版), 2011, 14(6): 329-330.

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