腺扁桃体切除术减少阻塞性睡眠呼吸暂停并改善成人患者的睡眠质量。

IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Júlia Pereira Toledo, Ana Carolina Ribeiro de Oliveira, Larissa Fontes Germano Santana, Sérgio Gomes da Silva, Fabrizio Dos Santos Cardoso
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引用次数: 0

摘要

背景:腺扁桃体切除术被广泛认为是儿童阻塞性睡眠呼吸暂停(OSA)的一线治疗方法;然而,它在成人患者中的有效性和临床作用仍然不太明确。目的:研究目的是测量成人腺扁桃体切除术后睡眠质量和OSA风险的变化。研究设计、环境、样本:这是一项在巴西RJ州Itaperuna的Unimed进行的前瞻性队列研究,包括28名诊断为OSA的成年患者。预测因素/暴露/自变量:主要预测变量为时间点(术前vs术后2个月)。主要结局变量:主要结局变量是治疗反应,用睡眠质量、OSA风险和白天疲劳来衡量。协变量:年龄、性别、体重指数和基线睡眠质量。分析:采用χ2、Fisher精确检验和Wilcoxon检验进行描述性和推断性分析(P)。结果:样本包括28名受试者,平均年龄28.4岁(±9.1岁),其中15名(53.6%)为男性。腺扁桃体切除术改善睡眠质量,降低OSA风险。结论和相关性:在有明显扁桃体或腺样体肥大和OSA的成年人中,腺扁桃体切除术与睡眠质量改善和OSA风险降低相关。对于不能忍受持续气道正压或存在解剖性上气道阻塞的患者,它可能是一种可行的替代方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adenotonsillectomy Reduces Obstructive Sleep Apnea and Improves Sleep Quality in Adult Patients.

Background: Adenotonsillectomy is widely established as a first-line treatment for obstructive sleep apnea (OSA) in children; however, its effectiveness and clinical role in adult patients remain less well defined.

Purpose: The study purpose was to measure changes in sleep quality and OSA risk in adults following adenotonsillectomy.

Study design, setting, sample: This was a prospective cohort study conducted at Unimed, in Itaperuna, RJ, Brazil, including 28 adult patients diagnosed with OSA.

Predictor/exposure/independent variable: The primary predictor variable was the time point (preoperative vs 2 months postoperative).

Main outcome variables: The main outcome variable was therapeutic response, measured using sleep quality, OSA risk, and daytime fatigue.

Covariates: Age, sex, body mass index, and baseline sleep quality.

Analyses: Descriptive and inferential analyses were performed using χ2, Fisher's exact, and Wilcoxon tests (P < .05).

Results: The sample included 28 subjects with a mean age of 28.4 years (±9.1), of whom 15 (53.6%) were male. Adenotonsillectomy improved sleep quality and reduced OSA risk. The proportion of subjects classified as high-risk for OSA decreased from 71.73 to 0% (P < .0001). Median Pittsburgh Sleep Quality Index scores improved from 9.5 (interquartile range 6 to 11) presurgery to 2.0 (1 to 4) postsurgery (P < .0001). In addition, daytime fatigue and snoring frequency also showed marked reductions postoperatively (P < .0001).

Conclusions and relevance: Among adults with significant tonsillar or adenoidal hypertrophy and OSA, adenotonsillectomy was associated with improvements in sleep quality and reduced OSA risk. It may represent a viable alternative for patients who cannot tolerate continuous positive airway pressure or present anatomical upper airway obstruction.

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来源期刊
Journal of Oral and Maxillofacial Surgery
Journal of Oral and Maxillofacial Surgery 医学-牙科与口腔外科
CiteScore
4.00
自引率
5.30%
发文量
0
审稿时长
41 days
期刊介绍: This monthly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association.
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