中国耳鼻咽喉头颈外科2024,Vol.31Issue(5) :326-329.DOI:10.16066/j.1672-7002.2024.05.012

低龄阻塞性睡眠呼吸暂停患儿围手术期危险因素分析

Analysis of perioperative risk factors in young children with obstructive sleep apnea

娄凡 明澄 祖金艳 赵丽萍 马静
中国耳鼻咽喉头颈外科2024,Vol.31Issue(5) :326-329.DOI:10.16066/j.1672-7002.2024.05.012

低龄阻塞性睡眠呼吸暂停患儿围手术期危险因素分析

Analysis of perioperative risk factors in young children with obstructive sleep apnea

娄凡 1明澄 1祖金艳 1赵丽萍 1马静1
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作者信息

  • 1. 昆明市儿童医院,昆明医科大学附属儿童医院耳鼻咽喉头颈外科,云南 昆明 650228
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摘要

目的 探讨低龄阻塞性睡眠呼吸暂停(OSA)患儿围手术期的危险因素.方法 将2020年1月~2022年12月昆明医科大学附属儿童医院耳鼻咽喉头颈外科收治的86例低龄OSA患儿,按术后治疗情况分为普通病房组与重症监护(ICU)病房组,比较分析两组患儿的临床资料.结果 ICU病房组患儿的病程、手术时间长于普通病房组,阻塞性呼吸暂停低通气指数(OAHI)、氧减指数(ODI)、术中出血量大于或多于普通病房组,平均血氧饱和度(mean oxygen saturation,MSaO2)、最低血氧饱和度(lowest oxygen saturation,LSaO2)低于普通病房组,扁桃体大小分级、手术方式,以上参数两组差异比较有统计学意义(P<0.05);而性别、年龄、体重、身高、体重指数(BMI)、腺样体大小分级比较,差异比较无统计学意义(P>0.05).两组患儿的OAHI值与MSaO2、LSaO2呈显著负相关(r=-0.676、-0.724),与扁桃体大小分级、ODI、手术时间、术中出血量呈显著正相关(r=0.242、0.967、0.321、0.446,P<0.05),而与病程无显著相关性(r=0.172,P>0.05).多元线性回归分析显示LSaO2、ODI是患儿病情严重程度的独立危险因素(P<0.05).结论 低龄OSA患儿的病情严重程度决定围手术期的风险,并受手术方式的影响.LSaO2、ODI作为独立危险因素应得到临床医师的广泛重视.

Abstract

OBJECTIVE To explore the perioperative risk factors in young children with obstructive sleep apnea.METHODS The 86 young OSA children admitted to Kunming Children's Hospital from January 2020 to December 2022 were divided into general ward group and ICU ward group according to their postoperative treatment.The clinical data of the two groups were compared and analyzed.RESULTS The course of disease and operation time of children in ICU ward group were significantly longer than those in general ward group,OAHI and ODI were significantly greater than those in general ward group,the intraoperative blood loss was significantly more than that in general ward group,MSaO2 and LSaO2 were significantly lower than those in general ward group,and the tonsil size and operation method composition ratio were significantly different from those in general ward group(P<0.05).There were no significant differences in sex composition ratio,age,weight,height,BMI and adenoid size grading ratio between the two groups(P>0.05).The OAHI values of the two groups were significantly negatively correlated with MSaO2 and LSaO2(r=-0.676,-0.724),and significantly positively correlated with tonsil size grade,ODI,operation time and intraoperative blood loss(r=0.242,0.967,0.321,0.446,P<0.05).There was no significant correlation with the course of disease(r=0.172,P>0.05).Multiple linear regression analysis showed that LSaO2 and ODI were independent risk factors for the severity of the child's condition.CONCLUSION The severity of the condition in young OSA children determines the perioperative risk and is influenced by the type of surgery.LSaO2 and ODI are independent risk factors which should be taken seriously by clinicians.

关键词

睡眠呼吸暂停,阻塞性/儿童/围手术期/危险因素

Key words

Sleep Apnea,Obstructive/Child/Perioperative/Risk Factors

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基金项目

昆明市卫生健康委卫生科研项目(2022-07-01-001)

出版年

2024
中国耳鼻咽喉头颈外科
中国医疗保健国际交流促进会 北京市耳鼻咽喉科研究所

中国耳鼻咽喉头颈外科

CSTPCDCSCD
影响因子:0.667
ISSN:1672-7002
参考文献量6
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