腺样体扁桃体切除术对阻塞性睡眠呼吸暂停综合征儿童脉络膜厚度及近视进展的影响

亚庆 吴(浙江省东阳市人民医院耳鼻咽喉科，中国)

摘要

目的：探讨腺样体扁桃体切除术对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）儿童脉络膜厚度及眼轴增长的影响，分析其对近视进展的潜在作用。方法：采用前瞻性随访研究设计，纳入在东阳市人民医院确诊为 OSAHS 并接受腺样体扁桃体切除术的儿童 30 例，年龄 6~12 岁。所有患儿于术前及术后 1 年接受系统眼科检查，包括增强深度成像光学相干断层扫描（enhanced depth imaging optical coherence tomography，EDI-OCT）测量脉络膜厚度，眼轴长度（axial length，AL）及屈光状态评估。比较术前与术后 1 年各项眼部参数的变化。结果：术后 1 年，OSAHS 儿童中心凹下、鼻侧及颞侧脉络膜厚度均较术前明显增加，差异均具有统计学意义（均P＜0.05）。术后 1 年眼轴平均增长为（0.35±0.24）mm，屈光度平均进展为（0.65±0.44）D。结论：腺样体扁桃体切除术可改善 OSAHS 儿童的脉络膜厚度，并可能减缓眼轴过度增长，对近视进展具有潜在的保护作用。早期手术干预或有助于减轻 OSAHS 对儿童眼部发育的不良影响。

关键词

阻塞性睡眠呼吸暂停综合征；腺样体扁桃体切除术；脉络膜厚度；眼轴；近视；儿童

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DOI: http://dx.doi.org/10.12345/yzlcyxzz.v9i3.37303