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目的探讨腺样体、扁桃体切除术对睡眠呼吸障碍儿童行为异常的治疗作用。方法采用32导多导睡眠仪及Polysmith睡眠分析软件对65例睡眠打鼾儿童进行整夜睡眠监测,根据诊断标准将其分为阻塞性睡眠呼吸暂停低通气综合征(OSAHS)组、单纯打鼾组和健康对照组。应用Conners简明症状问卷评定儿童行为问题,比较36例OSAHS组与29例单纯打鼾组行手术治疗前后异常行为的改善情况。结果OSAHS组及单纯打鼾组存在行为问题的比率高于健康对照组,但差异无统计学意义(P>0.05)。行腺样体、扁桃体手术前后Conners行为简明症状问卷得分OSAHS组由14.2±3.8下降到6.7±3.1(P<0.05);单纯打鼾组由9.4±4.1下降到5.1±2.8(P<0.05);OSAHS组存在行为异常者术前19例(52.3%)术后6例(16.7%),χ2=4.347 8,P<0.05;单纯打鼾组存在行为异常者术前14例(48.3%)术后4例(13.8%),χ2=5.263 2,P<0.05。结论OSAHS及单纯打鼾组儿童有较多的行为问题出现。腺样体、扁桃体切除术对睡眠呼吸障碍儿童行为异常有明显的治疗作用。
Objective To investigate the therapeutic effect of adenoid and tonsillectomy on behavioral disorders in children with sleep-disordered breathing. Methods Sixty-five sleep-snoring children were monitored for sleep by night using a 32-lead polysomnography and Polysmith sleep analysis software. According to diagnostic criteria, they were divided into obstructive sleep apnea-hypopnea syndrome (OSAHS) group, simple snoring group Healthy control group. Conners brief symptom questionnaire was used to assess children’s behavioral problems. The improvement of abnormal behavior before and after surgery was compared between 36 OSAHS patients and 29 simple snoring patients. Results There was a higher rate of behavioral problems in the OSAHS group and the simple snoring group than in the healthy control group, but the difference was not statistically significant (P> 0.05). The score of Conners Concise Symptom Inventory before and after tonsil surgery decreased from 14.2 ± 3.8 to 6.7 ± 3.1 (P <0.05) in OSAHS group, and decreased from 9.4 ± 4.1 to 5.1 ± 2.8 in OSAHS group (P <0.05). OSAHS There were 19 patients (52.3%) in operation group and 6 patients (16.7%) after operation, χ2 = 4.347 8, P <0.05. There were 14 patients (48.3%) in preoperative snoring group and 4 patients (13.8%), χ2 = 5.263 2, P <0.05. Conclusion There were more behavioral problems in children with OSAHS and simple snoring groups. Adenoid, tonsillectomy for children with sleep apnea disorders have a significant behavioral abnormalities.