儿童OSAHS术后的行为状况调查研究

发布时间：2019-06-08 06:45

【摘要】：目的通过对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿术前与术后行为状况比较，探讨手术对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿的行为状况是否改善，为阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿行手术治疗提供理论依据。实验方法随机收集2010年4月~2012年1月宁医大附院耳鼻咽喉头颈外科住院并行手术（扁桃体和/或腺样体切除术）的OSAHS患儿80例，术前均进行多导睡眠检测(PSG)监测、Achenlach儿童行为测试量表（CBCL）测试和病程统计，并同患儿家属协商，嘱其术后六个月后来我院复诊，行Achenlach儿童行为测试量表（CBCL）测试和病程统计，其中实验组为临床确诊为儿童OSAHS并已行手术治疗的患儿80例，年龄在2～11岁；对照组为术前同组患儿（80例）和健康儿童（80例）。采用一般情况调查问卷、Achenbach儿童行为量表(CBCL)，分别记录三组儿童体格生长指标和心理行为能力的测试结果.采用spss13.0统计学软件对实验数据进行统计学分析。结果①OSAHS患儿术后的行为异常发生率为8.90%,与OSAHS术前对照组（39.22%）相比p＜0.01，有显著性差异；与健康儿童对照组（7.69%）相比p＞0.05，差异无统计学意义。②OSAHS儿童术后的行为问题明显低于OSAHS患儿术前对照组，，其中行为总粗分和以下各行为因子分的差异有统计学意义（p＜0.05）：4~5岁男童主要表现在抑郁、幼稚不成熟、分裂样、攻击、违纪5个行为因子；4~5岁女童主要表现在社交退缩、攻击、多动3个行为因子；6~11岁男童主要表现在分裂样、抑郁、交往不良、强迫性、社交退缩、多动、攻击、违纪8个行为因子；6~11岁女童主要表现在抑郁、社交退缩、多动、性问题、攻击、残忍6个行为因子。OSAHS术后儿童组在行为总粗分及各行为因子分上均低于OSAHS患儿组，p＜0.05，有统计学意义；OSAHS术后儿童组在行为总粗分及各行为因子分上略高于正常儿童组，p＞0.05，无统计学意义。③OSAHS儿童术后的行为问题总粗分均随病程的延长而增加，但p＞0.05，无统计学意义。结论①OSAHS儿童术后组及OSAHS儿童术前组虽然都存在行为异常的问题，但术后组儿童行为问题的严重程度远远低于术前组儿童，且与正常儿童组行为状况无明显差异。②OSAHS儿童术后在不同性别之间及不同年龄段之间行为状况改善仍存在差异，但经统计学软件处理后无统计学意义。③OSAHS儿童术后组的行为状况随病情的加重及病程的延长改善程度相对减低，故对OSAHS患儿应尽早行手术治疗，使患儿的行为状况得到改善。
[Abstract]:Objective to compare the behavior of children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after operation, and to explore whether the operation can improve the behavior of children with obstructive sleep Apnea hypopnea syndrome (OSAHS). It provides a theoretical basis for surgical treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods from April 2010 to January 2012, 80 children with OSAHS who underwent otorhinolaryngology head and neck surgery (tonsillectomy and / or adenoidectomy) were randomly collected. (PSG) monitoring was performed before operation. Achenlach Child Behavioral Test scale (CBCL) test and course of disease statistics, and consulted with the child's family members, told his hospital to revisit six months after operation, Achenlach Child behavior Test scale (CBCL) test and course of disease statistics. Among them, 80 children with OSAHS diagnosed clinically and who had been treated surgically in the experimental group were aged 2 years old and 11 years old. The control group was the same group (80 cases) and healthy children (80 cases) before operation. The physical growth index and psychological and behavioral ability of the three groups were recorded by Achenbach Child behavior scale (CBCL),. Spss13.0 statistical software was used to analyze the experimental data. Results the incidence of abnormal behavior in children with 1OSAHS was 8.90%, which was significantly different from that in the control group before OSAHS (39.22%) (p < 0.01). Compared with the control group (7.69%), there was no significant difference between the two groups (p > 0.05). The postoperative behavioral problems of 2OSAHS children were significantly lower than those of the pre-operation control group of OSAHS children. There was significant difference between the total gross score of behavior and the scores of the following behavioral factors (p < 0.05). The main behavioral factors were depression, immature immaturity, mitosis, aggression and discipline violation in boys aged 5 years old. 4 the 5-year-old girls were mainly manifested in three behavioral factors: social withdrawal, aggression and hyperactivity, and 6 / 11-year-old boys were mainly manifested in 8 behavioral factors: division, depression, poor communication, obsessive-compulsive, social withdrawal, hyperactivity, aggression and violation of discipline. 6 girls aged 11 years old were mainly manifested in depression, social withdrawal, hyperactivity, sexual problems, aggression and cruelty. The total gross scores of behavior and the scores of each behavioral factor in the children group after OSAHS were lower than those in the OSAHS group (p < 0.05). The total gross scores of behavior and the scores of various behavioral factors in the children group after OSAHS were slightly higher than those in the normal children group (p > 0.05), there was no statistical significance. 3The total gross scores of behavioral problems in the children with OSAHS increased with the prolongation of the course of disease, but p > 0.05. There is no statistical significance. Conclusion although there are abnormal behavior problems in the postoperative group of 1OSAHS children and the preoperative group of OSAHS children, the severity of behavioral problems in the postoperative group is much lower than that in the preoperative group. There was no significant difference in behavioral status between 2OSAHS group and normal child group. There were still differences in behavioral improvement between different genders and different ages after operation in 2OSAHS children. However, there was no statistical significance after treatment with statistical software. 3The behavior of children with OSAHS decreased with the aggravation of the disease and the prolongation of the course of disease, so that the children with OSAHS should be treated surgically as soon as possible so that the behavior of children with OSAHS should be improved as soon as possible.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R766

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