小儿睡眠呼吸暂停课件.ppt

1、睡眠的生理学意义 消除疲劳、恢复体力 保护大脑、恢复精力提高机体的免疫力对儿童，睡眠有促进生长发育的特殊意义Nelson 儿科学，17版，2007；99Nelson 儿科学，17版，2007；99Nelson 儿科学，17版，2007；99 WATERS K A,Am J Med Genet,1995,59(4):460-466.Hsueh-yu L,Chang Gung Med J,2009;32:24757AMERICAN THORACIC SOCIETY.Am J Respir Crit Care Med,1996,153(2):866-878.AMERICAN THORACIC SOC

2、IETY.Am J Respir Crit Care Med,1996,153(2):866-878.OSAS in children is a disorder of breathing OSAS in children is a disorder of breathing during sleepcharacterized by prolonged partial during sleepcharacterized by prolonged partial upper airway obstruction and/or intermittent upper airway obstructi

3、on and/or intermittent complete obstruction(obstructive apnea)complete obstruction(obstructive apnea)that disrupts normal ventilation during sleep that disrupts normal ventilation during sleep and normal sleep patterns.It is associated and normal sleep patterns.It is associated with symptoms includi

4、ng habitual(nightly)with symptoms including habitual(nightly)snoring,sleep difficulties,and/or daytime snoring,sleep difficulties,and/or daytime neurobehavioral problems.Complications neurobehavioral problems.Complications may include growth abnormalities,neurologic may include growth abnormalities,

5、neurologic disorders,and cor pulmonale,especially in disorders,and cor pulmonale,especially in severe cases.Various risk factors have beensevere cases.Various risk factors have beenidentified and are defined.identified and are defined.Carolyn E I-L，AJRCCM，2007；175：436441OSAS对机体的影响Oscar S C，Proc Am T

6、horac Soc,2008；5：274282Oscar S C，Proc Am Thorac Soc,2008；5：274282Kahn A，Sleep,1993;16:409413Crouzon syndromeOscar S C，Proc Am Thorac Soc,2008；5：274282Oscar S C，Proc Am Thorac Soc,2008；5：274282蒙逖航,医学综述,2008;14(20):31413143OSA引起心血管事件的细胞学机制Athanasios G，Chest，2008；134：324331A,adenoid;N,nasopharyngeal me

7、asurement;P,pharyngeal measurement;T,tonsil.T/P 0.479提示中重度OSA。A/N 0.74以上A M Li,Arch Dis Child 2002;87:156159 Liner LH,Curr Opin Pediatr,2006,18(3):272-276.S L Verhulst，Arch Dis Child 2006;91:233237Marcus CL,Pediatr Pulmonol,1992;13:1621Biban P,Pediatrics,1993;92:461463Brouillette R,J Pediatr.1984;10

8、5:1014William WH，Pediatrics Current diagnosis&Treatment，19th ed，2009；467McColley S，Arch Otolaryngol Head Neck Surg，1992；118（9）：940943Goldberg S，Pediatr Pulmonol，2005；40（3）：205210Rosen GM，Pediatrics，1994；93（5）：784788Gorur K,Int J Pediatr Otorhinolaryngol,2001,59(1):41-46.Basha S,Laryngoscope,2005,115

9、(6):1101-1103.Mitchell Int JPediatrOtorhinolaryngol,2004,68(11):1375-1379.张亚梅,王桂香.中国全科医学,2007,10(2):102-104.年幼儿因颅面生长快年幼儿因颅面生长快,应每应每6 6月评价月评价1 1次次不同年龄段nCPAP的成功率nCPAP简便易行，依从性好，在多数病例可长期应用Massa F，Arch Dis Child，2002；87：438443FT 失败例ST 成功例不同年龄段nCPAP的成功率Massa F，Arch Dis Child，2002；87：438443Craig AH，Neuropsychi Dis Treat，2006；2（3）：30926Craig AH，Neuropsychi Dis Treat，2006；2（3）：30926 Hoban TF,Neurologist,2005,11(6):325-337.Aviv DG,Am J Respir Crit Care Med，2005，172；364370Raanan A，Am J Respir Crit Care Med，2005，172；264265谢谢您的关注！