CAJ | 학술논문

目的了解胸腹矛盾呼吸在儿童夜间睡眠呼吸中的出现情况,探讨胸腹矛盾呼吸在儿童睡眠呼吸疾病诊断中的意义.方法选取有睡眠呼吸障碍主诉的儿童38例为实验组;同期收集无睡眠打鼾、张口呼吸、呼吸暂停,无腺样体和(或)扁桃体肥大的儿童志愿者26例为对照组.所有入组儿童均进行整夜多道睡眠图(PSG)监测.根据记录数据判断矛盾呼吸,比较胸腹矛盾呼吸在两组儿童中出现的情况.结果睡眠过程中胸腹矛盾呼吸在实验组和对照组中均有发生,矛盾呼吸总时间((-x)±s,以下同)实验组为:(70.1±40.4)min,对照组为(28.2±25.7)min,两组差异有统计学意义(t=5.060,P＜0.05);矛盾呼吸占总睡眠时间的比例(时间构成比)实验组与对照组分别为:17.9%±11.0%和7.3%±6.8%,两组差异有统计学意义(t=4.767,P＜0.05).依据儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的诊断和病情严重程度判断标准,把有睡眠呼吸障碍症状主诉的儿童,进一步分为实验组的正常-轻度组(18例)和中-重度组(20例).正常-轻度组儿童的矛盾呼吸表现比中-重度组和对照组儿童的更为明显,正常-轻度组、中-重度组和对照组儿童矛盾呼吸时间分别为(85.9±31.7)min、(55.8±42.7)min和(28.2±25.7)min,3组数据比较差异有统计学意义(F=15.897,P＜0.05);3组矛盾呼吸时间构成比分别为22.0%±10.2%、14.1%±10.5%和7.3%±6.8%,差异也有统计学意义(F=14.167,P＜0.05).结论睡眠过程中过多胸腹矛盾呼吸的出现是一种异常的呼吸形式,矛盾呼吸可能是向低通气及呼吸暂停过度的异常呼吸形式,是气道阻力增加的表现,对睡眠呼吸疾病的诊断可能有提示作用.
목적 료해흉복모순호흡재인동야간수면호흡중적출현정황,탐토흉복모순호흡재인동수면호흡질병진단중적의의.방법 선취유수면호흡장애주소적인동38례위실험조;동기수집무수면타한、장구호흡、호흡잠정,무선양체화(혹)편도체비대적인동지원자26례위대조조.소유입조인동균진행정야다도수면도(PSG)감측.근거기록수거판단모순호흡,비교흉복모순호흡재량조인동중출현적정황.결과 수면과정중흉복모순호흡재실험조화대조조중균유발생,모순호흡총시간((-x)±s,이하동)실험조위:(70.1±40.4)min,대조조위(28.2±25.7)min,량조차이유통계학의의(t=5.060,P＜0.05);모순호흡점총수면시간적비례(시간구성비)실험조여대조조분별위:17.9%±11.0%화7.3%±6.8%,량조차이유통계학의의(t=4.767,P＜0.05).의거인동조새성수면호흡잠정저통기종합정(OSAHS)적진단화병정엄중정도판단표준,파유수면호흡장애증상주소적인동,진일보분위실험조적정상-경도조(18례)화중-중도조(20례).정상-경도조인동적모순호흡표현비중-중도조화대조조인동적경위명현,정상-경도조、중-중도조화대조조인동모순호흡시간분별위(85.9±31.7)min、(55.8±42.7)min화(28.2±25.7)min,3조수거비교차이유통계학의의(F=15.897,P＜0.05);3조모순호흡시간구성비분별위22.0%±10.2%、14.1%±10.5%화7.3%±6.8%,차이야유통계학의의(F=14.167,P＜0.05).결론 수면과정중과다흉복모순호흡적출현시일충이상적호흡형식,모순호흡가능시향저통기급호흡잠정과도적이상호흡형식,시기도조력증가적표현,대수면호흡질병적진단가능유제시작용.
Objective Abnormal breathing during sleep included many patterns. In this study, we investigated paradoxical breathing patterns during sleep in children using standard polysomnography (PSG).Methods Children who come to the ENT because of snoring were included into the study consecutively.Those who had craniofacial anomalies, diabetes, chronic lung diseases, and neuromuscular diseases were excluded. At the same time -no sleep snoring children were include as controls. Thirty-eight snoring children and twenty-six no snoring children were recruited. Polysomnography (PSG) was performed on all subjects.We determined the frequency of paradoxical breathing patterns during sleep through blind analysis of polysomnograms obtained in all subjects and compared the difference between children with snoring and normal controls. Results The appearance of paradoxical breathing was assessed in all subjects. Among children with snoring, the apparent amount of paradoxical breathing time and the percent of paradoxical breathing time spent in total sleep time ((-x) ± s) were (70. 1 ± 40. 4) min and 17.9% ± 11.0% respectively.Comparing with control group ( 28. 2 ± 25.7 ) min and 7. 3% ± 6. 8%, there was obvious difference ( paradoxical breathing time t = 5. 060, percent of paradoxical breathing time t = 4. 767, P ＜ 0. 05 ). Thirtyeight snoring children were divided into normal-mild group ( eighteen children) and moderate-severe group (twenty children). The children whose PSG results were normal and mild had more paradoxical breathing time and the percent of paradoxical breathing time than moderate-severe group. The apparent amount of paradoxical breathing time of normal-mild group, moderate-severe group and control group were (85.9 ±31.7)min, ( 55.8 ± 42. 7 ) min and ( 28. 2 ± 25.7 ) min. Among the three groups, there was obvious difference ( F = 15. 897, P ＜ 0. 05 ). The percent of paradoxical breathing time of the three groups were 22.0% ±10.2%,14.1% ±10.5% and 7. 3% ±6.8% (F=14.167, P＜0.05). Conclusions Currently published polysomnographic scoring recommendations overlook some common breathing abnormalities during sleep that are associated with clinical complaints. Paradoxical breathing is abnormal breathing patterns during sleep and its appearance is used to aid in the identification of respiratory events.