定量组织速度成像对阻塞性睡眠呼吸暂停低通气综合征患儿左心功能的研究

发布时间：2018-03-19 06:04

本文选题：睡眠呼吸暂停低通气综合征　切入点：阻塞性　出处：《临床耳鼻咽喉头颈外科杂志》2014年12期 　论文类型：期刊论文

【摘要】：目的:应用定量组织速度成像(QTVI)评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿腺样体和(或)扁桃体切除术前、后左心功能变化,探讨儿童OSAHS对左心功能的影响及QTVI的临床应用价值,确定手术对儿童OSAHS的治疗作用。方法:根据AHI将经PSG确诊的55例扁桃体和(或)腺样体肥大的OSAHS患儿分为轻度、中度及重度组;39例中、重度OSAHS患儿接受腺样体和(或)扁桃体切除术,将其中25例术后随访6个月再行PSG及QTVI的患儿设为实验组;选取20名正常儿童为对照组,应用QTVI技术进行检测。结果:术前OSAHS中度及重度组Va高于对照组,重度组Ve/Va低于对照组,差异均有统计学意义(P0.05),Vs各组间差异无统计学意义(P0.05)。术后6个月AHI及Va均降低,与术前组比较差异有统计学意义(P0.05),与对照组比较差异无统计学意义(P0.05)。Ve/Va手术前后各组间差异无统计学意义(P0.05)。结论:中、重度OSAHS患儿早期有不同程度左室舒张功能下降,二尖瓣环QTVI技术参数能够敏感反映OSAHS患儿左心功能早期改变,在判断左心功能早期变化方面有重要价值。手术切除腺样体和(或)扁桃体是治疗儿童OSAHS的有效方法,可使心肌功能障碍发生逆转。
[Abstract]:Objective: to evaluate the changes of left ventricular function in children with obstructive sleep apnea hypopnea syndrome (OSAHS) before adenoid and / or tonsillectomy using quantitative tissue velocity imaging (QTVI). To investigate the effect of OSAHS on left ventricular function and the clinical application value of QTVI in children, and to determine the therapeutic effect of operation on OSAHS in children. Methods: according to AHI, 55 cases of OSAHS with tonsil and / or adenoid hypertrophy diagnosed by PSG were classified as mild. In 39 cases of moderate and severe OSAHS, adenoid and / or tonsillectomy was performed on 25 of them, 25 of them were followed up 6 months after operation for PSG and QTVI, and 20 normal children were selected as control group. Results: the Va of the moderate and severe OSAHS group was higher than that of the control group, and the Ve/Va of the severe group was lower than that of the control group. There was no significant difference between the two groups. The AHI and Va decreased 6 months after operation. Compared with the preoperative group, the difference was statistically significant (P 0.05), and there was no significant difference between the two groups before and after the operation. Conclusion: the left ventricular diastolic function decreased in the early stage of moderate and severe OSAHS, and there was no significant difference between the two groups before and after the operation. The QTVI parameters of mitral annulus can sensitively reflect the early changes of left ventricular function in children with OSAHS, and have important value in judging the early changes of left ventricular function. Surgical resection of adenoids and / or tonsils is an effective method for the treatment of OSAHS in children. It can reverse myocardial dysfunction.
【作者单位】：山东大学齐鲁儿童医院耳鼻咽喉科;山东大学附属省立医院口腔颌面外科;山东大学齐鲁儿童医院超声科;山东大学附属济南市中心医院耳鼻咽喉-头颈外科;山东大学附属省立医院耳鼻咽喉-头颈外科;
【基金】：济南市卫生局科技计划项目(No:2008-61)
【分类号】：R766

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