夜间血氧仪在儿童阻塞性睡眠呼吸暂停筛查中的实际应用

C Hartnett, A Wilson, D Kilner, K Davies, N Slee, J Chawla, K Iyer, A Kevat
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摘要

阻塞性睡眠呼吸暂停(OSA)是儿童的常见问题,如果不及时治疗,可导致发育和认知并发症。诊断的金标准工具是多导睡眠图(PSG);然而,这是一项昂贵且耗时的测试。过夜血氧仪被认为是一种更快、更便宜的替代PSG的方法,因为它可以在家中使用有限的、可重复使用的设备进行。本研究旨在评估家庭血氧测定服务(为应对常规PSG延长的等待时间而实施)在减少患者转诊和治疗之间的时间方面的有效性。自2021年昆士兰儿童医院家庭血氧仪服务成立以来,所有使用该服务的患者(n=165)与2018年接受PSG的历史患者组(n=313)进行了比较。从要求睡眠相关研究到最终治疗(耳鼻喉外科手术或持续气道正压试验)的时间显著缩短(HITH血氧仪组为161天,PSG组为348天;p值<0.02),血氧仪组患者从睡眠研究请求到报告结果的时间明显低于PSG组(12天vs 86天p值<0.01)。这些结果表明,家庭血氧测量服务可以有效地减少被诊断为阻塞性睡眠呼吸暂停的患者接受治疗的等待时间。进一步的研究应检查更大的样本量,以确认研究结果,调查该服务的健康经济影响,并探讨患者/家庭的观点。
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O017 Real-World Utility of Overnight Oximetry for the Screening of Obstructive Sleep Apnoea in Children
Abstract Obstructive sleep apnoea (OSA) is a common problem in children, and can result in developmental and cognitive complications if untreated. The gold-standard tool for diagnosis is polysomnography (PSG); however, it is an expensive and time-consuming test to undertake. Overnight oximetry has been suggested as a faster and cheaper alternative to PSG as it can be performed at home using limited, reusable equipment. This study aims to evaluate the effectiveness of a home oximetry service (implemented in response to extended waiting times for routine PSG) in reducing the time between patient referral and treatment. All patients who utilised the Queensland Children’s Hospital home oximetry service since its inception in 2021 (n=165) were compared to a historic group of patients who underwent PSG in 2018 (n=313). The time from request of the sleep-related study to definitive treatment (ENT surgery or continuous positive airway pressure trial) was significantly reduced (161 days for the HITH oximetry group vs 348 days for the comparable PSG group; p-value &lt;0.02), and time from sleep study request to the report of results was significantly lower for patients in the oximetry group compared to those in the PSG group (12 days vs 86 days p-value &lt;0.01). These results suggest that a home oximetry service can be effective in reducing the waiting time for patients diagnosed with OSA to receive treatment. Further research should examine larger sample sizes to confirm the study findings, investigate the health economic impacts of the service and explore patient/family perspectives.
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