目的:针对持续性儿童阻塞性睡眠呼吸暂停(OSA)制定专家共识声明,重点关注质量改进和争议澄清。持续性OSA定义为腺样体扁桃体切除术后的OSA或扁桃体切除术后的OSA,当腺样体未扩大时。
方法:由临床医生组成的专家小组,由利益相关者组织提名,使用美国耳鼻咽喉头颈外科学会发表的共识声明方法,为2-18岁儿童的目标人群制定声明.医学图书馆员系统地搜索了用作临床陈述基础的文献。使用改进的德尔菲法提炼出专家意见,并撰写符合共识标准化定义的陈述。在最终的德尔菲调查之前,重复的陈述被合并。
结果:经过3次迭代德尔菲调查,34项声明符合共识标准,18个陈述没有。临床陈述分为7类:一般,患者评估,肥胖患者的管理,医疗管理,药物诱导睡眠内窥镜检查,手术管理,和术后护理。
结论:专家组就与评估有关的34项声明达成共识,儿童持续性OSA的管理和术后护理。这些陈述可以用来建立护理算法,改善临床护理,并确定将从未来研究中受益的领域。
To develop an expert consensus statement regarding persistent pediatric obstructive sleep apnea (OSA) focused on quality improvement and clarification of controversies. Persistent OSA was defined as OSA after adenotonsillectomy or OSA after tonsillectomy when adenoids are not enlarged.
An expert panel of clinicians, nominated by stakeholder organizations, used the published consensus statement methodology from the American Academy of Otolaryngology-Head and Neck Surgery to develop statements for a target population of children aged 2-18 years. A medical librarian systematically searched the literature used as a basis for the clinical statements. A modified Delphi method was used to distill expert opinion and compose statements that met a standardized definition of consensus. Duplicate statements were combined prior to the final Delphi survey.
After 3 iterative Delphi surveys, 34 statements met the criteria for consensus, while 18 statements did not. The clinical statements were grouped into 7 categories: general, patient assessment, management of patients with obesity, medical management, drug-induced sleep endoscopy, surgical management, and postoperative care.
The panel reached a consensus for 34 statements related to the assessment, management and postoperative care of children with persistent OSA. These statements can be used to establish care algorithms, improve clinical care, and identify areas that would benefit from future research.