Text/Yangcheng Evening News all-media reporter Zhang Hua Correspondent Zhang Yang
Photo/Courtesy of the hospital
"I was rejected by my roommates, and they all thought I was upset with them." Recently, 12-year-old Xiao Xuan told the doctor about his sadness in the consultation room of the Department of Otorhinolaryngology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University. What's going on?
It turned out that Xiao Xuan often snored when he slept at night, and after living on campus, it seriously affected the rest of his dormitory classmates. At the same time, because of snoring, he himself slept unsteadily, and the next day he was often listless and unable to lift his spirits. Snoring has seriously affected his studies and life.
Xiao Xuan's waist circumference reached 105 cm
12-year-old elementary school students sleep with extremely dangerous lack of oxygen
Xiao Xuan's father heard that snoring is a disease, and snoring affects Xiao Xuan's studies, so he took him to the hospital for treatment. After a detailed examination by Liang Faya, director of the Department of Otorhinolaryngology, Head and Neck of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, the specific reason was found.
"Fiber laryngoscopy shows bilateral tonsils also reaching 3 degree hypertrophy. Your child's adenoids block the back nostrils by 60%, which is the main cause of snoring in children. ”
In addition, although Xiao Xuan is only 12 years old, he is a small fat man. The abdominal circumference is 105 cm, the weight is up to 94 kg, and the BMI is 34.1, which is severe obesity. Due to obesity, the tissues around the child's pharyngeal cavity are still prone to collapse, which can also increase the severity of sleep snoring.
Subsequently, Xiao Xuan was hospitalized and first underwent sleep breath monitoring and found that the low ventilation index of obstructive apnea was 92.6 (normal value ≤1), and the minimum blood oxygen saturation at night was only 28% (normal value ≥ 95%).
"The child's lack of oxygen during sleep is severe, which is an extremely dangerous state, and it is likely to induce sudden death." Liang Faya said. This statement has made parents and children aware of the seriousness of the problem.
What is even more surprising to parents is that the routine preoperative examination after admission found that Xiaoxuan had impaired glucose tolerance, and the abdominal ultrasound showed that he had severe fatty liver. "A series of examinations showed that Xiaoxuan had suffered from obesity, tonsil and adenoidal hypertrophy, sleep apnea syndrome, fatty liver, prediabetes, etc."
Xiao Xuan is in the hospital for sleep monitoring
25% of pediatric snoring patients are obese
According to statistics, the Department of Otolaryngology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University was hospitalized with nearly 700 pediatric snoring patients last year, of which 25% were accompanied by obesity. Therefore, fat mounds like Xiao Xuan must lose weight.
Under the guidance of the Department of Pediatrics and Nutrition, Xiaoxuan began to control diet and adjust blood sugar, and wore a non-invasive ventilator to improve nighttime sleep ventilation and blood oxygen. After nearly a week of adjustment, Xiaoxuan's lack of oxygen at night has been better improved.
Adenoidal and tonsil hypertrophy is also one of the important reasons for Xiaoxuan's snoring. To treat this problem, surgery is necessary, Liang Faya performed "bilateral tonsillar hypothermal plasma resection + nasal endoscopic adenoid hypothermia plasma resection" for Xiaoxuan, which broadened the breathing channels of the oropharynx and nasopharynx, and Xiaoxuan felt that the symptoms of nocturnal breathing effort were significantly alleviated after surgery.
After returning to the hospital for a review after a month, Xiao Xuan said, "After the operation, my breathing was smooth, and I also made the snoring disappear when I went to bed with a ventilator, and now my classmates can understand me and have been good friends again." ”
Liang Faya also encouraged Xiaoxuan that if he reduced his weight to normal levels, he could get out of the ventilator, and his blood sugar and fatty liver would also turn normal.
Obesity forms a vicious circle with snoring
"Pediatric snoring and obesity form a vicious circle." Han Ping, deputy chief physician of the Department of Otorhinolaryngology at Sun Yat-sen Memorial Hospital of Sun Yat-sen University, pointed out that the traditional concept of "fat is a blessing" is a misunderstanding.
"Childhood obesity not only predisposes to snoring, which in turn exacerbates obesity, leading to a vicious circle, but also causes multi-system hazards that lead to metabolic disorders, insulin resistance and diabetes, cardiovascular disease, non-alcoholic steatohepatitis, certain types of cancer, musculoskeletal and psychological disorders, and a significantly increased risk of death."
Xiao Xuan's previous BMI reached 34.1, which was already severely obese, while the minimum blood oxygen was only 28%, which was an extremely dangerous state in sleep. Therefore, experts remind parents to pay attention to their children's weight.
In addition, experts also pointed out that the purpose of pediatric snoring treatment is to restore normal breathing channels. On the basis of careful examination, the principle of individualized treatment should be followed, and children with moderate and severe snoring with adenoids and/or tonsil hypertrophy should be recommended as the first treatment for adenoids and/or tonsillectomy, and if necessary, a noninvasive ventilator should be assisted for continuous positive pressure ventilation therapy; if necessary, children with snoring disease have no adenoids and/or tonsil hypertrophy, further comprehensive assessment of the upper airway conditions such as the mouth and nasal cavity, such as allergic rhinitis, sinusitis, etc., then use the corresponding drug treatment, And regular follow-up to evaluate the efficacy and possible adverse reactions, timely adjustment of the program.
Therefore, when parents find that their children have persistent sleep snoring, open mouth breathing, sleep instability, daytime sleepiness, attention deficit or hyperactivity, decreased academic performance, etc., they should seek the help of a specialist in time to identify whether it is pediatric snoring and carry out targeted treatment. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Cui Wencan