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目的探讨基层医院小儿阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的诊断和治疗。方法对临床疑似患儿,用多功能监测仪行夜间持续脉搏氧饱和度和呼吸监测、头颈侧位摄片、纤维鼻咽镜检查,确诊后行手术治疗。结果患儿多有睡眠粗响鼾声、扁桃体和(或)腺样体肥大,呼吸道感染、中耳炎、发育不良及中枢系统并发症的发生率较高。最低氧饱和度(85±7)%,睡眠呼吸暂停指数(apneaindex,AI)≥1者22例,睡眠呼吸暂停低通气指数(apneahypopneaindex,AHI)≥5者30例。在全麻下行扁桃体和腺样体切除术,同时行改良悬雍垂腭咽成形3例,双侧鼓膜切开引流术15例。术后症状及相关指标改善明显。结论便携式多功能监测仪可精确诊断OSAHS,扁桃体和腺样体切除是有效的治疗方法。
Objective To investigate the diagnosis and treatment of pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) in primary hospitals. Methods Suspected children with clinical suspicion of continuous pulse oxygen saturation and respiratory monitoring at night, lateral head and neck radiography, fiber nasopharyngeal examination, confirmed by surgery. Results Children had more sleep snoring loudly, tonsils and / or adenoid hypertrophy, respiratory infections, otitis media, dysplasia and central nervous system complication rate is higher. The lowest oxygen saturation (85 ± 7)%, sleep apnea (AI) ≥ 1 in 22 cases and sleep apnea hypopnea index (AHI) ≥ 5 in 30 cases. Under general anesthesia tonsil and adenoidctomy, while modified uvulopalatopharyngoplasty in 3 cases, bilateral tympanotomy incision and drainage in 15 cases. Postoperative symptoms and related indicators improved significantly. Conclusions The portable multi-function monitor can accurately diagnose OSAHS, tonsillectomy and adenoidectomy are effective treatments.