儿童阻塞性睡眠呼吸暂停低通气综合征治疗的研究进展

doi:10.3969/j.issn.1672-8467.2020.05.022

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复旦学报(医学版) ›› 2020, Vol. 47 ›› Issue (05) : 783-788. DOI: 10.3969/j.issn.1672-8467.2020.05.022

综述

儿童阻塞性睡眠呼吸暂停低通气综合征治疗的研究进展

郭靖晗^1,2, 李远远^1,2, 刘月华^1,2

作者信息 +

Overview on treatment of obstructive sleep apnea-hypopnea syndrome in children

GUO Jing-han^1,2, LI Yuan-yuan^1,2, LIU Yue-hua^1,2

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文章历史 +

摘要

儿童阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）是指因部分或全部上气道阻塞引起的通气障碍，可扰乱儿童正常呼吸和睡眠，影响儿童生长发育，甚至导致错颌畸形的疾病，是当前耳鼻咽喉及正畸科研究的热点问题。目前对于儿童OSAHS的治疗方式多样，以正畸治疗和手术治疗较为常见，而正畸与手术等多学科的联合治疗当下愈发突显地位。本文将对目前儿童OSAHS的多种治疗方法及其适应证的研究进展作一综述，并重点介绍儿童OSAHS的正畸治疗方法及该领域的研究现况。

Abstract

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a hot topic in otorhinolaryngology and orthodontics.OSAHS is a ventilatory disorder characterized by recurrent narrowing or collapse of upper airway,which can disturb children's normal breathing during sleep and sleep patterns.Pediatric OSAHS affects children's growth and development,and may lead to malocclusions.At present,the treatment methods of OSAHS in children varies,orthodontic treatment and surgical treatment become the most common ones,and the multidisciplinary combination treatment is appreciated by clinicians increasingly.This article will review the research progress of various treatment methods and their indications of pediatric OSAHS,and the orthodontic treatment of OSAHS in children and the current research status in this field will be mainly introduced.

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郭靖晗, 李远远, 刘月华. 儿童阻塞性睡眠呼吸暂停低通气综合征治疗的研究进展[J]. 复旦学报(医学版), 2020, 47(05): 783-788 https://doi.org/10.3969/j.issn.1672-8467.2020.05.022

GUO Jing-han, LI Yuan-yuan, LIU Yue-hua. Overview on treatment of obstructive sleep apnea-hypopnea syndrome in children[J]. Fudan University Journal of Medical Sciences, 2020, 47(05): 783-788 https://doi.org/10.3969/j.issn.1672-8467.2020.05.022

中图分类号： R783.5

参考文献

[1] MARCUS CL,BROOKS LJ,DRAPER KA,et al. Diagnosis and management of childhood obstructive sleep apnea syndrome[J].Pediatrics,2012,130(3):e714-e755.
[2] LUMENG JC,CHERVIN RD.Epidemiology of pediatric obstructive sleep apnea[J].Proc Am Thorac Soc,2008,5(2):242-252.
[3] ANDERSEN IG,HOLM JC,HOMOE P.Obstructive sleep apnea in children and adolescents with and without obesity[J].Eur Arch Otorhinolaryngol,2019,276(3):871-878.
[4] NARANG I,MATHEW JL.Childhood obesity and obstructive sleep apnea[J].J Nutr Metab,2012,2012:134202.
[5] VERHULST SL,SCHRAUWEN N,HAENTJENS D,et al.Sleep-disordered breathing in overweight and obese children and adolescents:prevalence,characteristics and the role of fat distribution[J].Arch Dis Child,2007,92(3):205-208.
[6] DAVIES CR,HARRINGTON JJ.Impact of obstructive sleep apnea on neurocognitive function and impact of continuous positive air pressure[J].Sleep Med Clin,2016,11(3):287-298.
[7] HODGES E,MARCUS CL,KIM JY,et al.Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome:incidence,demographic factors,and changes following a randomized controlled trial of adenotonsillectomy[J].Sleep,2018,41(12):1-8.
[8] KHAYAT R,PLEISTER A.Consequences of obstructive sleep apnea:cardiovascular risk of obstructive sleep apnea and whether continuous positive airway pressure reduces that risk[J].Sleep Med Clin,2016,11(3):273-286.
[9] XU TT,YOU D,CHEN X.Non-surgical treatment of obstructive sleep apnea syndrome[J].Eur Arch Otorhinolaryngol,2018,275(2):335-346.
[10] 刘月华.正畸医生在生命全周期上气道管理中的作用[J].中国实用口腔科杂志,2017,10(2):65-69.
[11] KIM EJ,CHOI JH,KIM KW,et al.The impacts of open-mouth breathing on upper airway space in obstructive sleep apnea:3-D MDCT analysis[J].Eur Arch Otorhinolaryngol,2011,268(4):533-539.
[12] RUHLE KH,NILIUS G.Mouth breathing in obstructive sleep apnea prior to and during nasal continuous positive airway pressure[J].Respiration,2008,76(1):40-45.
[13] IZU SC,ITAMOTO CH,PRADELLA-HALLINAN M,et al.Obstructive sleep apnea syndrome (OSAS) in mouth breathing children[J].Braz J Otorhinolaryngol,2010,76(5):552-556.
[14] 朱敏.张口呼吸的诊断与治疗[J].中国临床医生,2013,41(7):8-9.
[15] CHUNG LENG MUNOZ I,BELTRO ORTA P.Comparison of cephalometric patterns in mouth breathing and nose breathing children[J].Int J Pediatr Otorhinolaryngol,2014,78(7):1167-1172.
[16] LIONE R,BUONGIORNO M,FRANCHI L,et al.Evaluation of maxillary arch dimensions and palatal morphology in mouth-breathing children by using digital dental casts[J].Int J Pediatr Otorhinolaryngol,2014,78(1):91-95.
[17] VILLA MP,RIZZOLI A,RABASCO J,et al.Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children[J].Sleep Med,2015,16(6):709-716.
[18] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉科学分会.儿童阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案(乌鲁木齐)[J].中华耳鼻咽喉头颈外科杂志,2007,42(2):83-84.
[19] CHANG TS,CHIANG RP.Total analysis of clinical factors for surgical success of adenotonsillectomy in pediatric OSAS[J].Eur Arch Otorhinolaryngol,2017,274(1):561-566.
[20] 尚伟.《国际睡眠疾病分类第三版》解读[J].山东大学耳鼻喉眼学报,2016,30(5):18-20.
[21] PIRELLI P,SAPOMARA M,GUILLEMINAULT C.Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea:a 12-year follow-up[J].Sleep Med,2015,16(8):933-935.
[22] GUILLEMINAULT C,MONTEYROL PJ,HUYNH NT,et al.Adeno-tonsillectomy and rapid maxillary distraction in pre-pubertal children,a pilot study[J].Sleep Breath,2011,15(2):173-177.
[23] CAMACHO M,CHANG ET,SONG SA,et al.Rapid maxillary expansion for pediatric obstructive sleep apnea:A systematic review and meta-analysis[J].Laryngoscope,2017,127(7):1712-1719.
[24] MACHADO-JUNIOR AJ,SIGNORELLI LG,ZANCANELLA E,et al.Randomized controlled study of a mandibular advancement appliance for the treatment of obstructive sleep apnea in children:A pilot study[J].Med Oral Patol Oral Cir Bucal,2016,21(4):e403-e407.
[25] ZHANG C,HE H,NGAN P.Effects of twin block appliance on obstructive sleep apnea in children:a preliminary study[J].Sleep Breath,2013,17:1309-1314.
[26] PAVONI C,CRETELLA LOMBARDO E,LIONE R,et al.Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion[J].Acta Otorhinolaryngol Ital,2017,37(6):479-485.
[27] BUCCHERI A,CHINE F,FRATTO G,et al.Rapid maxillary expansion in obstructive sleep apnea in young patients:cardio-respiratory monitoring[J].J Clin Pediatr Dent,2017,41(4):312-316.
[28] KUSHIDA CA,BERRY RB,BLAU A,et al.Positive airway pressure initiation:a randomized controlled trial to assess the impact of therapy mode and titration process on efficacy,adherence,and outcomes[J].Sleep,2011,34(8):1083-1092.
[29] WEAVER TE,GRUNSTEIN RR.Adherence to continuous positive airway pressure therapy:the challenge to effective treatment[J].Proc Am Thorac Soc,2008,5(2):173-178.
[30] HEDNER J,ZOU D.Drug therapy in obstructive sleep apnea[J].Sleep Med Clin,2018,13(2):203-217.
[31] MARKLUND M,CARLBERG B,FORSGREN L,et al.Oral appliance therapy in patients with daytime sleepiness and snoring or mild to moderate sleep apnea:a randomized clinical trial[J].JAMA Intern Med,2015,175(8):1278-1285.
[32] DOFF MH,HOEKMA A,WIJKSTRA PJ,et al.Oral appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome:a 2-year follow-up[J].Sleep,2013,36(9):1289-1296.
[33] VENEKAMP RP,HEARNE BJ,CHANDRASEKHA-RAN D,et al.Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children[J].Cochrane Database Syst Rev,2015,10:CD011165.
[34] LEE CH,HSU WC,CHANG WH,et al.Polysomnographic findings after adenotonsillectomy for obstructive sleep apnoea in obese and non-obese children:a systematic review and meta-analysis[J].Clin Otolaryngol,2016,41(5):498-510.
[35] GOLDBART AD,GREENBERG-DOTAN S,TAL A.Montelukast for children with obstructive sleep apnea:a double-blind,placebo-controlled study[J].Pediatrics,2012,130(3):e575-e580.
[36] KHEIRANDISH-GOZAL L,BANDLA HP,GOZAL D.Montelukast for children with obstructive sleep apnea:results of a double-blind,randomized,placebo-controlled trial[J].Ann Am Thorac Soc,2016,13(10):1736-1741.
[37] CHAN CC,AU CT,LAM HS,et al.Intranasal corticosteroids for mild childhood obstructive sleep apnea——a randomized,placebo-controlled study[J].Sleep Med,2015,16(3):358-363.
[38] KHEIRANDISH-GOZAL L,GOZAL D.Intranasal budesonide treatment for children with mild obstructive sleep apnea syndrome[J].Pediatrics,2008,122(1):e149-e155.
[39] DE FELICIO CM,SILVA DIAS FVDA,TRAWITZKI LVV.Obstructive sleep apnea:focus on myofunctional therapy[J].Nat Sci Sleep,2018,10:271-286.
[40] HUANG YS,HSU SC,GUILLEMINAULT C,et al.Myofunctional therapy:role in pediatric OSA[J].Sleep Med Clin,2019,14(1):135-142.
[41] CHUANG LC,LIAN YC,HERVY-AUBOIRON M,et al.Passive myofunctional therapy applied on children with obstructive sleep apnea:A 6-month follow-up[J].J Formos Med Assoc,2017,116(7):536-541.
[42] GUIMARAES KC,DRAGER LF,GENTA PR,et al.Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome[J].Am J Respir Crit Care Med,2009,179(10):962-966.
[43] VILLA MP,EVANGELISTI M,MARTELLA S,et al.Can myofunctional therapy increase tongue tone and reduce symptoms in children with sleep-disordered breathing?[J].Sleep Breath,2017,21(4):1025-1032.

基金

上海申康医院发展中心促进市级医院临床技能与临床创新三年行动计划（16CR2044B）；上海市卫生和计划生育委员会青年项目（20184Y0018）；上海市卫生健康委先进适宜技术推广项目（2019SY041）；上海市口腔病防治院院级项目（SSDC-2019-ZDXK02）

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收稿日期	出版日期
2019-07-24	2020-09-25
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2020-09-25

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