JAMA OHNS:儿童睡眠呼吸障碍的诊断和治疗时机——公共医疗保险能否保障?

2014-12-15 张嘉良译 MedSci原创

睡眠呼吸障碍(sleep disordered breathing,SDB)或呼吸暂停(sleep apnea)是指一组发生在睡眠状态下的呼吸疾病,表现为在睡眠过程中反复间断出现呼吸停顿或低通气。小儿SDB由于夜间缺氧、C02滞留,干扰脑组织能量代谢,患儿白天多表现为晨起头痛、嗜睡、烦躁、易激惹、注意力不集中,甚至性格、行为异常。30%~50%患儿生长发育不同程度落后于同龄儿,长期上呼吸道阻塞,张

睡眠呼吸障碍(sleep disordered breathing,SDB)或呼吸暂停(sleep apnea)是指一组发生在睡眠状态下的呼吸疾病,表现为在睡眠过程中反复间断出现呼吸停顿或低通气。小儿SDB由于夜间缺氧、C02滞留,干扰脑组织能量代谢,患儿白天多表现为晨起头痛、嗜睡、烦躁、易激惹、注意力不集中,甚至性格、行为异常。30%~50%患儿生长发育不同程度落后于同龄儿,长期上呼吸道阻塞,张口呼吸可影响面部及牙齿发育,甚至出现腺样体面容,如长脸、下颌骨平面较陡、颌后缩,安静时上下唇张开,上唇相对较短。严重的低氧血症、高碳酸血症还会引起心血管并发症,危及患儿生命,如发作频繁或持续时间过长可引起肺动脉高压、右心衰竭及肺心病,缺氧发作时还可引起心动过缓、心律失常、甚至心跳停止、缺氧性晕厥。因此,小儿SDB的早期诊断及治疗,对患儿的生长发育乃至身心健康均具有重要意义。调查显示,低社会经济地位(SES)的儿童患有SDB风险较高,但他们获得专科护理的机会却往往是有限的。多导睡眠图(PSG)是用于诊断表征SDB及阻塞性睡眠呼吸暂停的金标准测试。然而,SES是否影响儿童及时进行PSG检查乃至得到

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    2015-04-21 jbliufj

    文章有启发性

    0

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    2015-02-14 liuyier

    zhangsan?

    0

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    2015-01-26 pengyikun

    此文比较有意义。

    0

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    2014-12-17 xuyu
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    2014-12-17 feifers

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