药物诱导睡眠内窥镜在儿童阻塞性睡眠呼吸暂停诊疗中的应用

doi:10.12372/jcp.2025.24e1292

Abstract

Abstract:

Objective To investigate the application of drug-induced sleep endoscopy (DISE) in pediatric obstructive sleep apnea (OSA). Methods The clinical data of children diagnosed with OSA by polysomnography (PSG) and DISE examination were retrospectively analyzed from June 1, 2023 to June 1, 2024 in the Department of Otorhinolaryngology. The NAVOTEL scoring system was used to score DISE, and the correlation between DISE score and apnea-hypopnea index (AHI) and minimum arterial oxygen saturation (SaO₂) was analyzed. Results DISE tests were performed in 163 children (114 boys and 49 girls), and the median age was 7.0 (5.0-9.0) years. The most common obstructive site was the velopharynx (137 cases, 84.0%), followed by the lateral oropharynx (124 cases, 76.1%), nasal cavity (95 cases, 58.3%), adenoid (92 cases, 56.4%), base of the tongue (52 cases, 31.9%), epiglottis (30 cases, 18.4%), and larynx (3 cases, 1.8%). The most common obstruction site in children of different age groups (≤5 years old, 6~10 years old and 11~18 years old) was velopharynx, accounting for 81.0%, 86.2% and 83.3%, respectively. Spearman rank correlation analysis showed that the total NAVOTEL score of 163 children was significantly positively correlated with AHI (r_s=0.48, P<0.01), and significantly negatively correlated with the lowest SaO₂ (r_s=-0.35, P<0.01). The NAVOTEL score of palatopharyngeal obstruction was positively correlated with AHI (r_s=0.33, P<0.01) and negatively correlated with the lowest SaO₂(r_s=-0.48, P<0.01). Conclusions DISE can be used to evaluate the site and severity of upper airway obstruction in children with OSA, and its score is correlated with AHI and minimum SaO₂, which can cooperate with PSG to improve the diagnosis and treatment level of OSA in children.

Key words: obstructive sleep apnea, drug-induced sleep endoscopy, child

CLC Number:

ZHANG Zhihai, TANG Xinye, YAO Hongbing, WANG Bing, XIAO Ling, YANG Yang. Application of drug-induced sleep endoscopy in pediatric obstructive sleep apnea[J].Journal of Clinical Pediatrics, 2025, 43(11): 830-836.

Figures/Tables 4

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References 39

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项目	结果
男[n(%)]	114(69.9)
年龄[M(P₂₅~P₇₅)]/岁	7.0(5.0~9.0)
身高($\bar{x}±s$)/cm	125.3±18.2
体重[M(P₂₅~P₇₅)]/kg	28.0(20.0~37.0)
BMI($\bar{x}±s$)/kg·m^-2	18.1±4.1
肥胖[n(%)]	5(3.1)
偏瘦[n(%)]	88(54.0)
PSG[n(%)]
轻度OSA	95(58.3)
中度OSA	41(25.1)
重度OSA	27(16.6)
AHI[M(P₂₅~P₇₅)]/次·h^-1	8.8(6.9~16.3)
最低SaO₂($\bar{x}±s$)/%	72.9±11.8
BIS值($\bar{x}±s$)	72.0±1.7

阻塞部位	NAVOTEL评分[M(P₂₅~P₇₅)]	评分0[n(%)]	评分1[n(%)]	评分2[n(%)]	总阻塞[n(%)]
鼻腔	1.0(0~1.0)	68(41.7)	94(57.7)	1(0.6)	95(58.3)
腺样体	1.0(0~1.0)	71(43.6)	80(49.1)	12(7.4)	92(56.4)
腭咽	1.0(1.0~2.0)	26(16.0)	79(48.5)	58(35.6)	137(84.0)
咽侧壁	1.0(1.0~2.0)	39(23.9)	68(41.7)	56(34.4)	124(76.1)
舌根	0(0~1.0)	111(68.1)	46(28.2)	6(3.7)	52(31.9)
会厌	0(0~0)	133(81.6)	25(15.3)	5(3.1)	30(18.4)
喉部	0(0~0)	160(98.2)	3(1.8)	0(0)	3(1.8)

年龄	例数	阻塞部位[n(%)]
年龄	例数	鼻腔	腺样体	腭咽	咽侧壁	舌根	会厌	喉部
≤5岁	58	32(55.2)	32(55.2)	47(81.0)	41(70.7)	15(25.9)	14(24.1)	2(3.4)
6~10岁	87	53(60.9)	52(59.8)	75(86.2)	71(81.6)	29(33.3)	16(18.4)	0(0)
11~18岁	18	10(55.6)	8(44.4)	15(83.3)	12(66.7)	8(44.4)	0(0)	1(5.6)

Application of drug-induced sleep endoscopy in pediatric obstructive sleep apnea

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