【摘要】：目的通過對阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）患兒術(shù)前與術(shù)后行為狀況比較，探討手術(shù)對阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）患兒的行為狀況是否改善，為阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）患兒行手術(shù)治療提供理論依據(jù)。 實驗方法隨機收集2010年4月~2012年1月寧醫(yī)大附院耳鼻咽喉頭頸外科住院并行手術(shù)（扁桃體和/或腺樣體切除術(shù)）的OSAHS患兒80例，術(shù)前均進行多導睡眠檢測(PSG)監(jiān)測、Achenlach兒童行為測試量表（CBCL）測試和病程統(tǒng)計，并同患兒家屬協(xié)商，囑其術(shù)后六個月后來我院復診，行Achenlach兒童行為測試量表（CBCL）測試和病程統(tǒng)計，其中實驗組為臨床確診為兒童OSAHS并已行手術(shù)治療的患兒80例，年齡在2～11歲；對照組為術(shù)前同組患兒（80例）和健康兒童（80例）。采用一般情況調(diào)查問卷、Achenbach兒童行為量表(CBCL)，分別記錄三組兒童體格生長指標和心理行為能力的測試結(jié)果.采用spss13.0統(tǒng)計學軟件對實驗數(shù)據(jù)進行統(tǒng)計學分析。 結(jié)果①OSAHS患兒術(shù)后的行為異常發(fā)生率為8.90%,與OSAHS術(shù)前對照組（39.22%）相比p＜0.01，有顯著性差異；與健康兒童對照組（7.69%）相比p＞0.05，差異無統(tǒng)計學意義。②OSAHS兒童術(shù)后的行為問題明顯低于OSAHS患兒術(shù)前對照組，，其中行為總粗分和以下各行為因子分的差異有統(tǒng)計學意義（p＜0.05）：4~5歲男童主要表現(xiàn)在抑郁、幼稚不成熟、分裂樣、攻擊、違紀5個行為因子；4~5歲女童主要表現(xiàn)在社交退縮、攻擊、多動3個行為因子；6~11歲男童主要表現(xiàn)在分裂樣、抑郁、交往不良、強迫性、社交退縮、多動、攻擊、違紀8個行為因子；6~11歲女童主要表現(xiàn)在抑郁、社交退縮、多動、性問題、攻擊、殘忍6個行為因子。OSAHS術(shù)后兒童組在行為總粗分及各行為因子分上均低于OSAHS患兒組，p＜0.05，有統(tǒng)計學意義；OSAHS術(shù)后兒童組在行為總粗分及各行為因子分上略高于正常兒童組，p＞0.05，無統(tǒng)計學意義。③OSAHS兒童術(shù)后的行為問題總粗分均隨病程的延長而增加，但p＞0.05，無統(tǒng)計學意義。 結(jié)論①OSAHS兒童術(shù)后組及OSAHS兒童術(shù)前組雖然都存在行為異常的問題，但術(shù)后組兒童行為問題的嚴重程度遠遠低于術(shù)前組兒童，且與正常兒童組行為狀況無明顯差異。②OSAHS兒童術(shù)后在不同性別之間及不同年齡段之間行為狀況改善仍存在差異，但經(jīng)統(tǒng)計學軟件處理后無統(tǒng)計學意義。③OSAHS兒童術(shù)后組的行為狀況隨病情的加重及病程的延長改善程度相對減低，故對OSAHS患兒應盡早行手術(shù)治療，使患兒的行為狀況得到改善。
[Abstract]:Objective to compare the behavior of children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after operation, and to explore whether the operation can improve the behavior of children with obstructive sleep Apnea hypopnea syndrome (OSAHS). It provides a theoretical basis for surgical treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods from April 2010 to January 2012, 80 children with OSAHS who underwent otorhinolaryngology head and neck surgery (tonsillectomy and / or adenoidectomy) were randomly collected. (PSG) monitoring was performed before operation. Achenlach Child Behavioral Test scale (CBCL) test and course of disease statistics, and consulted with the child's family members, told his hospital to revisit six months after operation, Achenlach Child behavior Test scale (CBCL) test and course of disease statistics. Among them, 80 children with OSAHS diagnosed clinically and who had been treated surgically in the experimental group were aged 2 years old and 11 years old. The control group was the same group (80 cases) and healthy children (80 cases) before operation. The physical growth index and psychological and behavioral ability of the three groups were recorded by Achenbach Child behavior scale (CBCL),. Spss13.0 statistical software was used to analyze the experimental data. Results the incidence of abnormal behavior in children with 1OSAHS was 8.90%, which was significantly different from that in the control group before OSAHS (39.22%) (p < 0.01). Compared with the control group (7.69%), there was no significant difference between the two groups (p > 0.05). The postoperative behavioral problems of 2OSAHS children were significantly lower than those of the pre-operation control group of OSAHS children. There was significant difference between the total gross score of behavior and the scores of the following behavioral factors (p < 0.05). The main behavioral factors were depression, immature immaturity, mitosis, aggression and discipline violation in boys aged 5 years old. 4 the 5-year-old girls were mainly manifested in three behavioral factors: social withdrawal, aggression and hyperactivity, and 6 / 11-year-old boys were mainly manifested in 8 behavioral factors: division, depression, poor communication, obsessive-compulsive, social withdrawal, hyperactivity, aggression and violation of discipline. 6 girls aged 11 years old were mainly manifested in depression, social withdrawal, hyperactivity, sexual problems, aggression and cruelty. The total gross scores of behavior and the scores of each behavioral factor in the children group after OSAHS were lower than those in the OSAHS group (p < 0.05). The total gross scores of behavior and the scores of various behavioral factors in the children group after OSAHS were slightly higher than those in the normal children group (p > 0.05), there was no statistical significance. 3The total gross scores of behavioral problems in the children with OSAHS increased with the prolongation of the course of disease, but p > 0.05. There is no statistical significance. Conclusion although there are abnormal behavior problems in the postoperative group of 1OSAHS children and the preoperative group of OSAHS children, the severity of behavioral problems in the postoperative group is much lower than that in the preoperative group. There was no significant difference in behavioral status between 2OSAHS group and normal child group. There were still differences in behavioral improvement between different genders and different ages after operation in 2OSAHS children. However, there was no statistical significance after treatment with statistical software. 3The behavior of children with OSAHS decreased with the aggravation of the disease and the prolongation of the course of disease, so that the children with OSAHS should be treated surgically as soon as possible so that the behavior of children with OSAHS should be improved as soon as possible.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R766

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