睡眠呼吸障碍为首发表现的Chiari畸形幼儿1例报道并文献复习

doi:10.6040/j.issn.1673-3770.0.2021.443

摘要/Abstract

摘要： 目的探讨中枢性睡眠呼吸暂停的特点及其引起疾病的临床特征,提高Chiari畸形合并中枢性睡眠呼吸暂停的认识。方法回顾性分析1例以睡眠呼吸障碍为首发表现的Chiari畸形患儿的临床资料,结合文献复习探讨Chiari畸形合并中枢性睡眠呼吸暂停(CSA)的特征。结果患儿通过影像学及多导睡眠监测证实符合Chiari畸形Ⅰ型合并CSA的特征。结合病例,复习、汇总国内外文献关于Chiari畸形的研究报道,共32例(成年男性1例,成年女性4例,幼儿男性12例,幼儿女性15例)。合并睡眠呼吸障碍22例,其中13例以阻塞型暂停为主、5例以中枢型暂停为主、1例为中枢型低通气、3例表现为中枢型和阻塞型并存。除1例合并阻塞型暂停患者行无创正压通气治疗,其他患者均行外科手术治疗。结论 Chiari畸形引起睡眠呼吸障碍的问题不容忽视,多导睡眠监测可以对睡眠呼吸特点进行客观评估和初步诊断,为临床治疗决策前提供更多的客观诊断依据。

关键词: 睡眠呼吸暂停, 中枢性, 阻塞性, Chiari畸形, 多导睡眠监测

Abstract: Objective To understand the characteristics of central sleep apnea and the clinical characteristics of the disease, and to improve the understanding of Chiari malformation combined with central sleep apnea. Methods The clinical data of a patient with Chiari malformation were retrospectively analyzed, and the characteristics of Chiari malformation combined with central sleep apnea were discussed combined with literature review. Results The child confirmed the characteristics of Chiari malformation type I combined with central sleep apnea by imaging and polysomnography. Review and summarize literatures related to Chiari malformation, together with this case, a total of 32 cases(1 adult male, 4 adult female, 12 young and young male, 15 young female)were reported. In 22 patients with sleep respiratory disorders, 13 were mainly obstructive pause, 5 were mainly central pause, one was central hypoventilation, and three showed both central and obstructive forms.Except for one patient with obstructive suspension, all the other patients underwent surgical treatment. Conclusion The problem of Chiari malformation causing sleep breathing disorder cannot be ignored. Polysomnography can help to make objective evaluation and preliminary diagnosis, and offer more information on characteristics of sleep and breathing before clinical treatment decision is made.

Key words: Sleep apnea, Central, Obstructive, Chiari malformation, Polysomnography

中图分类号:

R766

郑莉,许志飞. 睡眠呼吸障碍为首发表现的Chiari畸形幼儿1例报道并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 111-115.

ZHENG Li, XU Zhifei. A case of sleep disordered breathing is the first performance of Chiari deformity in young children report and literature revier[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 111-115.

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