Clinical Analysis Of Adenoid Hypertrophy Complicated With Lower Respiratory Tract Infection In Children With OSA

PurposeThough observation of the general clinical data,sleep monitoring results and the frequency of lower respiratory tract infection after lower respiratory tract resection of children with obstructive sleep apnea(OSA)of adenoid hypertrophy combined with lower respiratory tract infection,to explore whether there is reciprocal interaction between adenoid hypertrophy and lower respiratory tract infection in children diagnosed with OSA,and providing clinical data.MethodIn the past studies(2020.1～2022.9),there were 351 children with adenoid hypertrophy who confirmed OSAHS with sleep monitoring in the respiratory department or the ENT ward of Dalian Women and Children’s Medical Center(Group).The analysis results of body mass index(body mass index,BMI)and the results of sleep monitoring show that there were 213 children with OSA with adenoidal hypertrophy and 138 children with OSA with adenoid hypertrophy and lower respiratory tract infection.According to whether the lower respiratory tract infection is divided into simple group and combined group,respectively record the general situation and sleep monitoring results,through correlation analysis,chi-square test,rank sum test method comparison between the two groups,and the sleep monitoring results of lower respiratory tract infections were compared by ANOVA.Chi-square test was used to compare the frequency of upper respiratory tract infection and lower respiratory tract infection in 112 children with adenoidectomy in the simple group 1 year before surgery and 1 year after surgery.Result1.General clinical data:Among the 351 study subjects,232(66%)were male and119(34%)were female,with a male to female ratio of 1.94:1,mainly aged 3-7 years(58%).2.Correlation analysis between BMI value and the results of sleep monitoring in351 children:BMI value was positively correlated with obstructive apnea hypopnea index;BMI was positively correlated with the time proportion of non-rapid EM sleep(NREM);BMI was negatively associated with the proportion of rapid eye movement sleep(REM);the above data were statistically different(P <0.05).There was no obvious correlation between BMI and the lowest oxygen saturation,oxygen 96-100%time ratio,ratio of light sleep time,ratio of deep sleep and periodmean oxygen saturation.3.Simple groups and combined groups:3.1 In the combined group,there were 88 patients(64%)male,50 female(36%)female,144 male(68%)and 69 female(32%)in the pure group,respectively(P=0.489).By comparative analysis of BMI results of the two groups,BMI of the simple group was higher than BMI of the combined group,and the difference was statistically significant(P <0.05).3.2 Comparison of the sleep monitoring results:The mean blood oxygen saturation,OAHI and 96-100% time ratio of blood oxygen in simple groups were higher than those in combined groups,and the 91-95% time ratio of blood oxygen and 85-90% time ratio of blood oxygen in combined groups were higher than those in simple groups,the difference was statistically significant(P<0.05),and no significant in the blood oxygen80-84% time ratio,lowest blood oxygen saturation,NREM time ratio,REM time ratio and light sleep time ratio in two groups(P> 0.05).3.3 Comparison of the sleep monitoring results with different lower respiratory tract infections: The mean blood oxygen saturation in the bronchitis group was higher than that in the wheezing group.The proportion of blood oxygen 96-100% in the bronchitis group was higher than that of the pneumonia group and the wheezing group.The proportion of blood oxygen 91-95% in the bronchitis group was lower than that in the wheezing group and the pneumonia group.the difference was statistically significant(P <0.05).The above differences are statistically significant.4.In the children with diagnosed OSA,there was obvious reduced in the frequency of lower respiratory tract infection(pneumonia,bronchitis,wheezing bronchitis)and upper respiratory tract infection compared with that of surgery one year ago.The difference was statistically significant(P <0.05).Conclusion1.BMI was positively associated with OAHI in OSA children,and BMI and REM period time negatively,indicating that obesity is a risk factor for OSA,suggesting that obesity leads to disturbed sleep structure.2.OSA Hypoxia is more severe in children when combined with a lower respiratory tract infection.The heavier the degree of lower respiratory tract infection is,the more severe the degree of hypoxia is.3.After adenoidectomy for the OSA children,the frequency of upper respiratory tract infection and lower respiratory tract infection decreased significantly.When OSA with adenoid hypertrophy and lower respiratory tract infection,anti-infection treatment should be carried out actively.In clinical practice,children with recurrent upper and lower respiratory tract infections should be alert for the obstructive diseases of upper airway,such as adenoid hypertrophy.If there is adenoid hypertrophy,it should be treated early.