The significance of evaluation of sleep respiration in infants with Pierre Robin sequence
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摘要: 目的 通过PSG对皮罗序列征婴幼儿进行睡眠紊乱的评估，探讨其作为病情客观指标的可行性，了解此类患儿的睡眠呼吸特征。方法 采取PSG对17例皮罗序列征患儿进行>7 h的整夜睡眠监测，记录其睡眠呼吸、血氧等指标，并对监测的结果进行统计和分析。结果 14例(82.35%)皮罗序列征患儿存在不同程度的呼吸暂停、低通气及低氧血症，AHI为12.39±9.86，LSaO2为(84.12±8.12)%。不同性别的皮罗序列征婴幼儿AHI及LSaO2比较差异均无统计学意义，年龄与AHI呈负相关。结论 皮罗序列征多有不同程度的呼吸暂停和低氧血症，需要及早干预，年龄越小病情相对越重，PSG监测可为皮罗序列征的评估提供客观依据，对治疗有重要的指导意义。Abstract: Objective This study aimed to evaluate the sleep disorders of infants with Pierre Robin sequence by PSG, and to understand the sleep breathing characteristics of them.Method Seventeen patients with Pierre Robin sequence underwent polysomnography lasting over 7 hours. Sleep apnea and oxygen index was recorded and analyzed.Result 14(82.35%) patients with Pierre Robin sequence presented with apnea, hypopnea and hypoxemia with varying degree. The apnea-hypopnea index(12.39±9.86) and lowest arterial oxygen saturation(84.12±8.12) %were not significantly different between sexes. However, age showed a negative impact with apnea-hypopnea index, which was worse in younger infants.Conclusion Most patients with the Pierre Robin sequence have sleep apnea and hypoxemia, and appropriate management should be implemented in an early age. Polysomnography can provide objective analysis of the treatment.
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Key words:
- polysomnography /
- infant /
- Pierre Robin sequence /
- sleep apnea
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表 1 不同性别的患儿PSG结果分析
x±s 组别 例数 AHI OAI LSaO2 SaO2 < 90% 氧减指数 男性组 9 14.10±11.34 4.66±5.21 84.11±9.88 2.15±3.52 14.33±11.51 女性组 8 10.48±8.21 3.39±3.51 84.13±6.24 1.28±1.92 10.05±7.43 
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表 2 不同年龄的患儿多导睡眠监测结果分析
x±s 组别 例数 AHI OAI LSaO2 SaO2 < 90% 氧减指数 < 6个月组 9 18.47±9.96 6.49±4.92 81.00±9.84 3.19±3.31 18.44±9.71 ≥6个月组 8 5.56±2.87 1.33±0.75 87.63±3.66 0.11±0.23 5.43±2.72
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[1] Paes EC, van Nunen DP, Basart H, et al. Birth prevalence of Robin sequence in the Netherlands from 2000-2010: a retrospectivepopulation-based study in a large Dutch cohort and review of the literature[J]. Am J Med Genet A, 2015, 167A(9): 1972-1982.
[2] Logjes RJH, Haasnoot M, Lemmers PMA, et al. Mortality in Robin sequence: identification of risk factors[J]. Eur J Pediatr, 2018, 177(5): 781-789. doi: 10.1007/s00431-018-3111-4
[3] Van Heest T, Ebert B, Roby BB, et al. Upper airway obstruction in neonates: Does sleep exacerbate symptoms?[J]. Laryngoscope Investig Otolaryngol, 2018, 3(2): 78-81. doi: 10.1002/lio2.137
[4] Dorise B, Trivedi A, Galea C, et al. Feeding practices and growth of infants with Pierre Robin Sequence[J]. Int J Pediatr Otorhinolaryngol, 2019, 118: 11-14. doi: 10.1016/j.ijporl.2018.12.004
[5] Broucqsault H, Lamblin MD, Hosana G, et al. Evaluation of the efficacy of tongue-lip adhesion in Pierre Robin sequence[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2018, 135(3): 155-158. doi: 10.1016/j.anorl.2017.11.002
[6] Greathouse ST, Costa M, Ferrera A, et al. The Surgical Treatment of Robin Sequence[J]. Ann Plast Surg, 2016, 77(4): 413-419. doi: 10.1097/SAP.0000000000000630
[7] Zhang N, Mao Z, Cui Y, et al. Optimal duration of mechanical ventilation and influencing factors following mandibulardistraction osteogenesis in infants with Pierre Robin sequence[J]. Medicine(Baltimore), 2019, 98(51): e18339.
[8] Runyan CM, Uribe-Rivera A, Tork S, et al. Management of Airway Obstruction in Infants With Pierre Robin Sequence[J]. Plast Reconstr Surg Glob Open, 2018, 6(5): e1688. doi: 10.1097/GOX.0000000000001688
[9] Hammoudeh JA, Fahradyan A, Brady C, et al. Predictors of Failure in Infant Mandibular Distraction Osteogenesis[J]. J Oral Maxillofac Surg, 2018, 76(9): 1955-1965. doi: 10.1016/j.joms.2018.03.008
[10] 刘大波, 钟建文, 周丽枫, 等. 阻塞性睡眠呼吸暂停综合征对儿童身高、体重的影响[J]. 中国儿童保健杂志, 2003, 11(6): 423-424. doi: 10.3969/j.issn.1008-6579.2003.06.032
[11] 刘大波. 小儿耳鼻咽喉头颈外科疑难病案集[J]. 广州: 羊城晚报出版社, 2013: 7-7.
[12] 仇书要, 刘大波, 钟建文. 2018法国耳鼻咽喉头颈外科学会指南解读: 不同治疗方案在儿童OSAHS治疗中的地位[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(2): 97-100. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH202002001.htm
[13] 刘大波, 仇书要, 钟建文, 等. 伴高危因素儿童阻塞性睡眠呼吸暂停低通气综合征的手术治疗[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43(12): 924-928. doi: 10.3321/j.issn:1673-0860.2008.12.012
[14] Lam DJ, Jensen CC, Mueller BA, et al. Pediatric sleep apnea and craniofacial anomalies: a population-based case-control study[J]. Laryngoscope, 2010, 120(10): 2098-2105. doi: 10.1002/lary.21093
[15] 刘大波, 谭宗瑜, 钟建文, 等. 小儿阻塞性睡眠呼吸暂停综合征并肺动脉高压2例围术期处理回顾分析[J]. 中国实用儿科杂志, 2010, 25(10): 802-805. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201010025.htm
[16] Konofaos P, Puente-Espel J, Askandar S, et al. Mid-Term Outcome of Mandibular Distraction Osteogenesis in Pierre Robin Sequence[J]. J Craniofac Surg, 2019, 30(6): 1667-1670. doi: 10.1097/SCS.0000000000005436
[17] Opdenakker Y, Swennen G, Pottel L, et al. Postoperative Respiratory Complications After Cleft Palate Closure in Patients With Pierre RobinSequence: Operative Considerations[J]. J Craniofac Surg, 2017, 28(8): 1950-1954. doi: 10.1097/SCS.0000000000003995
[18] 谭宗瑜, 刘大波, 俞洁, 钟建文, 等. 儿童睡眠障碍就诊原因分析(附300例报告)[J]. 临床耳鼻咽喉头颈外科杂志, 2007, 21(13): 611-612. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH200713017.htm
[19] 滕利, 孙晓梅, 吴国平, 等. 下颌骨牵引成骨术治疗儿童小下颌畸形伴阻塞性睡眠呼吸暂停综合征[J]. 中华整形外科杂志, 2005, 21(4): 248-251. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHZX200504004.htm
[20] Khansa I, Hall C, Madhoun LL, et al. Airway and Feeding Outcomes of Mandibular Distraction, Tongue-Lip Adhesion, and ConservativeManagement in Pierre Robin Sequence: A Prospective Study[J]. Plast Reconstr Surg, 2017, 139(4): 975e-983e. doi: 10.1097/PRS.0000000000003167
[21] Breugem CC, Evans KN, Poets CF, et al. Best Practices for the Diagnosis and Evaluation of Infants With Robin Sequence: A Clinical Consensus Report[J]. JAMA Pediatr, 2016, 170(9): 894-902. doi: 10.1001/jamapediatrics.2016.0796
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