■目前,微创手术通常用于儿科患者的日间手术,以促进术后快速恢复。阻塞性睡眠呼吸暂停综合征(OSAS)患者术后在医院或家中的恢复可能因睡眠中断而在恢复质量和昼夜节律状态方面有所不同;然而,这仍然是未知的。儿科患者通常无法有效地解释自己的感受,衡量不同环境下恢复情况的客观指标是有希望的。进行这项研究是为了比较住院和家庭术后恢复质量(主要结果)和昼夜节律(通过唾液褪黑激素水平测量)(次要结果)对学龄前患者的影响。
■这是一个队列,非随机和探索性观察研究。总共招募了61名4至6岁的儿童,他们计划接受腺扁桃体切除术,并在手术后分配到医院(医院组)或家中(家庭组)康复。在基线时,医院组和家庭组之间的患者特征和围手术期变量没有差异。他们以同样的方式接受治疗和麻醉。收集患者术前和术后28天的OSA-18问卷。此外,手术前后唾液褪黑素浓度,体温,术后三晚睡眠日记,疼痛量表,出现激动,并记录其他不良反应。
■术后恢复质量无显著差异,根据OSA-18问卷的评估,体温,睡眠质量,疼痛量表,和其他不良事件(如呼吸抑制,窦性心动过缓,窦性心动过速,高血压,低血压,恶心,和呕吐)在两组之间。两组患者术前早晨唾液褪黑素分泌均在术后第1天下降(P<0.05),而Home组在术后第1天(P<0.05)和第2天(P<0.05)的下降幅度明显更大。
■根据OSA-18评估量表,医院学龄前儿童的术后恢复质量与在家一样好。然而,早晨唾液褪黑激素水平显著下降与家庭术后恢复的临床重要性尚不清楚,值得进一步研究.
UNASSIGNED: At present, minimally invasive surgery is often used in paediatric patients as a day surgery to promote rapid post-operative recovery. Obstructive Sleep Apnea Syndrome (OSAS) Patients recovery in the hospital or at home after surgery may differ in terms of recovery quality and circadian rhythm status because of sleep disruption; however, this remains unknown. Pediatric patients usually unable to explain their feelings effectively, and objective indicators to measure recovery situation in different environments are promising. This study was conducted to compare the impact of in-hospital and at-home postoperative recovery quality (primary outcome) and circadian rhythm (as measured via the salivary melatonin level) (secondary outcome) in preschool-age patients.
UNASSIGNED: This was a cohort, non-randomized and exploratory observational study. A total of 61 children aged 4 to 6 years who were scheduled to receive adenotonsillectomy were recruited and assigned to recover either in the hospital (Hospital group) or at home (Home group) after surgery. There were no differences in the patient characteristics and perioperative variables between the Hospital and Home groups at baseline. They received the treatment and anesthesia in the same way. The patients\' preoperative and up to 28 days post-surgery OSA-18 questionnaires were harvested. Moreover, their pre- and post-surgery salivary melatonin concentrations, body temperature, three-night postoperative sleep diaries, pain scales, emergence agitation, and other adverse effects were recorded.
UNASSIGNED: There were no significant differences in the postoperative recovery quality, as assessed by the OSA-18 questionnaire, body temperature, sleep quality, pain scales, and other adverse events (such as respiratory depression, sinus bradycardia, sinus tachycardia, hypertension, hypotension, nausea, and vomiting) between the two groups. The preoperative morning saliva melatonin secretion was decreased in both groups on the first postoperative morning (P<0.05), while a significantly greater decrease was found in the Home group on postoperative day 1 (P<0.05) and day 2 (P<0.05).
UNASSIGNED: The postoperative recovery quality of preschool kids in the hospital is as good as at home based on OSA-18 evaluation scale. However, the clinical importance of the significant decrease in morning saliva melatonin levels with at-home postoperative recovery remains unknown and warrants further study.