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目的探讨儿童阻塞性睡眠呼吸障碍疾病特异性生活质量调查表(OSD-6)在儿童睡眠呼吸紊乱评价中的作用。方法前瞻性对照临床研究,61例OSD-6调查评分提示为阻塞性睡眠呼吸暂停(OSA)的儿童,平均年龄(6.4±0.61)岁,女28例,男33例。其中多导睡眠监测(PSG)阳性32例均经腺样体和扁桃体切除术(A&T)治疗,PSG阴性儿童29例随机分别经A&T治疗(n=15)或非手术治疗(n=14)。1～3个月后以同样的方式进行评价。结果平均随访时间为(2.8±1.3)个月。PSG阴性A&T组儿童术后OSD-6调查总评分平均下降49(极值32～61)分,与非手术组儿童的平均变化总分8(极值-9～21)分比较差异有统计学意义。PSG阴性A&T组中的86.7%儿童术后提示为临床无症状者(OSD-6调查总评分<20分),而非手术组为14.2%两者比较差异有统计学意义。所有经手术治疗的儿童,术后身体症状的评分和睡眠障碍的评分明显下降。结论OSD-6调查评分提示为OSA但PSG为阴性的患儿,在A&T治疗后生活质量评分可以明显改善。该调查表能够反映出SDB儿童手术治疗的疗效,可以作为睡眠呼吸障碍(SDB)儿童的临床评价和疗效观察的工具。
Objective To investigate the role of OSD-6 in children with sleep-disordered breathing disorder assessment. Methods A prospective, controlled clinical study of 61 OSA children with OSA score of 61 (6.4 ± 0.61) years, 28 women and 33 males were included in the OSD-6 survey. Among them, 32 cases of positive polysomnography (PSG) were treated with adenomy and tonsillectomy (A & T), while 29 cases of PSG-negative children were treated with A & T (n = 15) or non-surgical treatment (n = 14). 1 to 3 months after the evaluation in the same way. Results The average follow-up time was (2.8 ± 1.3) months. The average score of OSD-6 in PSG-negative A & T group was 49 (extreme value 32-61), which was significantly lower than that of non-operation group (8-9) significance. 86.7% of children with PSG-negative A & T group had clinically asymptomatic postoperative symptoms (overall score of <20 points in OSD-6 survey) compared with 14.2% in non-operation group. There was significant difference between the two groups. All surgically treated children had significantly lower postoperative physical symptoms scores and sleep disorders scores. CONCLUSIONS: Children with OSA but negative PSG for OSD-6 survey score showed a significant improvement in quality of life after A & T treatment. This questionnaire reflects the efficacy of surgery in children with SDB and can be used as a tool for clinical evaluation and curative effect observation in children with sleep-disordered breathing (SDB).