Children With Obstructive Sleep Apnea Hypopnea Syndrom Impact On The Physical Development And Effects Of Surgical Treatment For Research

Objective The first part of study,by comparing the healthy children and obstructive sleep apnea hypopnea syndrom（OSAHS）children’s height（length）,weight,body mass index,physical development physique growth indexes such as the Z score,to understand objective evidence of the impact from the obstructive sleep apnea hypopnea syndrom（OSAHS）on children’s physical development and the characteristics of the influence of different age groups of children.The second part of the study,through comparing the physical development level of OSAHS children with physical underdevelopment before operation and 6 months and 12 months after undergoing combined adenoidectomy and tonsillectomy,at the same time through comparing polysomnography result of 6 months after operation and before,to understand the treatment effect of combined adenoidectomy and tonsillectomy on different age groups OSAHS children with physique underdevelopment,to investigate the appropriated timing to execute adenoidectomy and tonsillectomy intervention operation on OSAHS childrenMethods The first part from December 2015 to December 2015 in hunan children’s hospital otolaryngology head and neck surgery due to snoring sleep with mouth breathing,aged 0 to 9（≦9）,by physical examination and electronic nose throat mirror examination,diagnosis of adenoid hypertrophy and tonsil hypertrophy,and at the same time by polysomnography（PSG）diagnosis of OSAHS in children as the experimental group;Both in hunan children’s hospital medical examination,no sleep snoring and mouth breathing abnormal conditions,and the physical examination to eliminate tonsil hypertrophy 0 to 9（≦9）age children as control group.By age will be divided into two groups of children 0 to 3 years old（≦3）,3 to 4 years old（≦4）,4 to 5 years old（≦ 5）,5 to 6 years of age（≦6）,6 to 7 years old（≦7）,7 to 8（≦8）,8 to 9（≦9）,a total of seven ages collected into the children’s physique growth index and OSAHS children sleep monitoring results,mainly including height,weight,sleep apnea hypoventilation index（AHI）,night sleep the lowest oxygen saturation（LSaO₂）,height,weight,refer to the WHO standards into Body Mass Index（BMI）,Height for age Z score（HAZ）,Weight for age Z score（WAZ）.Comparison between the experimental group and control group in the two groups in age children’s height,weight,body mass index（BMI）,Height for age Z score,Weight for age Z score.The second part of the study: to select 242 cases of height and weight development lags behind,underwent adenoidectomy and tonsil resection of OSAHS children,as a surgical cases,postoperative follow-up study.By age is divided into 0 to 3 years old（≦3）,3 to 4 years old（≦4）,4 to 5 years old（≦5）,5 to 6 years of age（≦6）,6 to 7 years old（≦7）at the age of 7,7 to 8 years old（≦8）,8 to 9 years old（≦9）,a total of seven ages.After 6 months and 12 months for physical measurement,six months after polysomnography examination.According to the ages compared preoperative and postoperative sleep monitoring results and preoperative and postoperative June 6 months and 12 months of physical development level.Results The first part of study: a total of 3406 cases,aged 0 to 9 children enrolled OSAHS influence on children’s physical development control study,including the control group,1737 cases of experimental group 1669 cases.All ages sex ratio distribution,there was no statistically significant difference（P>0.05）,and all ages sample size distribution comparison between the two groups,there was no statistically significant difference（P>0.05）.Physical development indexes between the two groups: height: height are lower than the control group at all ages average,experimental group the difference was statistically significant（P< 0.05）.Weights are: 0 to 3 years,and 3 to 4 years old,4 to 5 years old,5 to 6 years old,6 to 7 years old,7 to 8 years old age group average weight is lower than the control group,the difference was statistically significant（P< 0.05）,8 to 9 years of age is compared between two groups,there was no statistically significant difference（P =0.156）.Body mass index（BMI）: 3 to 4 years old,4 to 5 years old,5 to 6 years old,6 to 7 years old age group were higher than the control group,the difference was statistically significant（P<0.05）,and 0 to 3 years old group and 7 to 8 years old age group comparison between the two groups,there was no statistically significant difference（P>0.05）.Physical development index Z score comparison: Height for age Z score t（HAZ）is compared between group: all age group were lower than control group,the difference was statistically significant（P < 0.05）.Weight for age Z score（WAZ）between group comparison: 0 to 3 years,and 3 to 4 years old,4 to 5 years old,5 to 6 years old,6 to 7 years old,7 to 8 years old age group were lower than the control group,the difference was statistically significant（P<0.05）,those aged between eight and nine comparison between the two groups,there was no statistically significant difference（P=0.14）.Height for age Z score（HAZ）: in the experimental way and 0 to 3 years old and 6 to 7 years old,7 to 8 years old,aged 8 to 9 comparison,the difference had statistical significance（P< 0.05）.3 to 4 and 6 to 7 years old,7 to 8 years old,aged 8 to 9 comparison,the difference had statistical significance（P < 0.05）.4 to 5 and 6 to 7 years old,7 to 8 years old,8 to 9 years of age,the difference had statistical significance（P<0.05）.Weight for age Z score（WAZ）is: in the experimental way and 0 to 3 years old and 5 to 6 years old,6 to 7 years old,7 to 8,8 to 9 years of age,the difference was statistically significant（P < 0.05）.3 to 4 and 5 to 6 years old,6 to 7 years old,7 to 8 years old,8 to 9 years of age,the difference was statistically significant（P<0.05）.4 to 5 and 7 to 8 years,8 to 9 years of age,the difference was statistically significant（P<0.05）.Experimental results of polysomnography comparison: the lowest oxygen saturation（LSaO₂）within the group comparison: 0 to 3 years and 3 to 4 years of age is higher than 5 to 9 years of age,the difference was statistically significant（P<0.05）;4 to 5 years old,5 to 6 years old ages 6 to 7 years old and above 8 to 9 years of age,the difference was statistically significant（P< 0.05）;0 to 3 years compared with 3 to 4 years of age,there was no statistically significant difference（P>0.05）,4 to 5 years old,5 to 6 years old,comparison between 6 to 7 years old age group,there was no statistically difference（P>0.05）.Apnea hypopnea index（AHI）within the group comparison: 0 to 3 years and 3 to 4 years of age is lower than 5 to 9 years of age,the difference was statistically significant（P<0.05）,4 to 5 years of age less than 6 to 7 years old,7 to 8 years,8 to 9 years of age,the difference was statistically significant（P < 0.05）,5 to 6 years old and aged 6 to 7 below 8 to 9 years of age,the difference was statistically significant（P< 0.05）.The second part of research: a total of 198 cases of complete follow-up and incorporated into the study.Aged 1 to 9（≦9）.Height for age Z score（HAZ）: all ages 12 months after compared with preoperative increases,the difference was statistically significant（P< 0.05）.0 to 3 years old,3 to 4 years old,aged 4 to 5,5 to 6,6 to 7 years old,6 years old in December 7 to 8 aged postoperative compared with postoperative June are improved,the difference was statistically significant（P<0.05）,postoperative December 8 to 9 years old age compared with postoperative June,increased Height for age Z score（HAZ）,there was no statistically significant difference（P=0.361）.Height for age Z score（HAZ）between December after all ages comparison: 0 to 3 years old and 5 to 6,7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）;3 to 4 and 5 to 6,7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）;4 to 5 years old and 5 to 6,7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）;5-6 and 7-8 years,8 to 9 years of age,the difference was statistically significant（P<0.05）;6 to 7 years old and 7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）.Weight for age Z score（WAZ）: all ages 12 months after compared with preoperative increases,the difference was statistically significant（P< 0.05）.0 to 3 years old,3 to 4 years old,aged 4 to 5,5 to 6 years old,aged 6 to 7 postoperative December compared with postoperative in June,the difference was statistically significant（P<0.05）.7 to 8 years old with December 8 to 9 years of age after compared with postoperative June,there was no statistically significant difference（P>0.05）.Weight for age Z score（WAZ）in December after comparison between all ages: 0 to 3 above 6 to 7 years old,aged 8 to 9,3 to 4 years old above 4 to 5 years of age,4 to 5 years old above 5 to 6 years old,6 to 7,8 to 9 years of age,7 to 8 years old above 8 to 9 years of age,differences were statistically significant（P<0.05）.Apnea hypoventilation index（AHI）preoperative comparison: after June all ages AHI are lower than the preoperative,postoperative difference was statistically significant（P<0.05）.Preoperative all ages between apnea hypoventilation index（AHI）: 0 to 3 years old and 5 to 6 years old,6 to 7 years old age group,the difference was statistically significant（P<0.05）;5 to 6 and 7-8 years,8 to 9 years of age,the difference was statistically significant（P<0.05）;6 to 7 years old compared with 7 to 8 years old age group,the difference was statistically significant（P<0.05）.Between June all ages postoperative apnea hypoventilation index（AHI）: 0 to 3 years old and 5 to 6 years old,6 to 7 years old,7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）;3 to 4 and 5 to 6 years old,6 to 7 years old,7 to 8 years old,8 to 9 years of age,the difference was statistically significant（P<0.05）;4 to 5 and 6 to 7 years old,7 to 8 years old,8 to 9 years of age,the difference was statistically significant（P<0.05）;5 to 6 years old,6 to 7 years old,and 7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）.Preoperative all ages between the lowest oxygen saturation（LSaO₂）comparison: 0 to 3 years old,3 to 4 years old,4 to 5 years of age,and 5 to 6 years old,6 to 7 years old age group,the difference was statistically significant（P<0.05）.5 to 6 years old,6 to 7 years old age group and 7 to 8,8 to 9 years of age,the difference was statistically significant（P < 0.05）.Between June all ages after the lowest oxygen saturation（LSaO₂）: 0 to 3 years,and 3 to 4 years of age with 4 to 5 years old,5 to 6 years old,6 to 7 years old,7 to 8,8 to 9 years of age,the difference was statistically significant（P < 0.05）.4 to 5 years old,5 to 6 years old,6 to 7 years old,and 7 to 8,8 to 9 years of age,the difference was statistically significant（P<0.05）.June,preoperative and postoperative results of polysomnography evaluation therapeutic effect: 0 to 3 years,and 3 to 4 years old,4 to 5 years old age AHI are less than 5 times/h or nearly five times/h,LSaO₂ > 92,reach the standard cure.5 to 6 years old,aged 6 to 7 AHI are nearly five times/h,LSaO₂ near 92,curative effect is distinct,close to heal and standard.7-8 years old,aged 8 to 9 postoperative AHI in preoperative lower than 50%,curative effect is remarkable.Conclusion OSAHS affect children’s physical development and physical development lag behind;Adenoidectomy and tonsil resection is an effective method for treating children OSAHS,it can effectively improve children’s physical development lag behind which were suffered from OSAHS.In order to improve the effect of treatment,surgery is recommended in preschool.