低温等离子腺样体+双侧扁桃体切除在小儿OSAHS治疗中的应用探讨
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摘要
目的:探讨在小儿阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的治疗中应用低温等离子腺样体+双侧扁桃体切除的作用。方法:随机将80例OSAHS患儿分为对照组和观察组,每组40例。观察组应用低温等离子腺样体切除+双侧扁桃体切除,对照组使用动力切割系统切除腺样体+常规剥离双侧扁桃体。对比两组的手术用时、术中出血量、住院时间,另外比较两组治疗前后的睡眠通气情况。结果:观察组的手术用时、住院时间短于对照组(P<0.05),观察组的术中出血量少于对照组(P<0.05);治疗后两组的呼吸暂停通气指数(AHI)均降低(P<0.05),最低动脉血样饱和度(LSaO_2)均提高(P<0.05),观察组优于对照组,差异有统计学意义(P<0.05)。结论:对小儿OSAHS应用低温等离子腺样体+双侧扁桃体切除治疗具有操作简单、出血少、术后恢复快的优势,且可更好地改善睡眠通气指标。
Objective:To investigate the effect of cryogenic plasma adenoidectomy plus bilateral tonsillectomy in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS) in children.Method:80 children with OSAHS were randomly divided into the control group and the observation group,with 40 cases in each group.The observation group was treated with cryogenic plasma adenoidectomy plus bilateral tonsillectomy,while the control group was treated with dynamic cutting system to remove the adenoids plus conventionally strip the bilateral tonsils.The operation time,intraoperative bleeding volume and hospitalization time were compared between the two groups,and the sleep ventilation were compared between the two groups before and after treatment.Result:The operation time and hospitalization time of the observation group were shorter than those of the control group(P<0.05),while the intraoperative bleeding volume of the observation group was less than that of the control group(P<0.05).After treatment,the AHI in both groups were decreased(P<0.05),and LSaO_2 were improved(P<0.05),which were significant difference between the observation group and the control group(P<0.05).Conclusion:The application of cryogenic plasma adenoidectomy plus bilateral tonsillectomy in children with OSAHS has the advantages of simple operation,less bleeding and quick recovery,and can better improve sleep ventilation index.
Objective:To investigate the effect of cryogenic plasma adenoidectomy plus bilateral tonsillectomy in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS) in children.Method:80 children with OSAHS were randomly divided into the control group and the observation group,with 40 cases in each group.The observation group was treated with cryogenic plasma adenoidectomy plus bilateral tonsillectomy,while the control group was treated with dynamic cutting system to remove the adenoids plus conventionally strip the bilateral tonsils.The operation time,intraoperative bleeding volume and hospitalization time were compared between the two groups,and the sleep ventilation were compared between the two groups before and after treatment.Result:The operation time and hospitalization time of the observation group were shorter than those of the control group(P<0.05),while the intraoperative bleeding volume of the observation group was less than that of the control group(P<0.05).After treatment,the AHI in both groups were decreased(P<0.05),and LSaO_2 were improved(P<0.05),which were significant difference between the observation group and the control group(P<0.05).Conclusion:The application of cryogenic plasma adenoidectomy plus bilateral tonsillectomy in children with OSAHS has the advantages of simple operation,less bleeding and quick recovery,and can better improve sleep ventilation index.
引文
[1]马鹏,冯俊,杜经纬.采用低温等离子刀腺样体切除治疗儿童OSAHS并发中耳炎临床效果观察[J].浙江临床医学,2017,19(12):2245-2246.
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[8]杨东宝,乔富玉,肖静.低温等离子法与传统手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征比较[J].现代仪器与医疗,2017,23(4):60-61.
[9]李达,刘玉欣,于海玲,等.儿童扁桃体及腺样体低温等离子切除术后出血的观察[J].齐鲁医学杂志,2017,32(4):444-446.
[10]杨东宝,肖静,徐海蓉.小儿鼾症治疗中内镜下低温等离子射频消融术与电刀凝切术的应用分析[J].中国妇幼健康研究,2017,28(S1):399-400.
[11]仇书要,刘大波,钟建文,等.儿童腺样体及扁桃体低温等离子消融术后腭瘘一例[J].中华耳鼻咽喉头颈外科杂志,2017,52(2):113-114.
[12]徐烨星,陈金辉,章薇,等.等离子刀扁桃体部分切除术联合腺样体射频消融术治疗儿童鼾症的短期疗效研究[J].现代生物医学进展,2017,17(6):1048-1052.
[13]李燕.腭咽成形术与低温等离子消融术治疗小儿鼾症的临床疗效分析[J].中南医学科学杂志,2017,45(6):637-640.
[2]吴昊,王东海.低温等离子腺样体切除联合双侧扁桃体切除治疗儿童鼾症的疗效观察[J].解放军预防医学杂志,2017,35(2):139-141.
[3]姜丽,李玉茹.低温等离子扁桃体部分消融术在治疗儿童阻塞性睡眠呼吸暂停综合征中的应用[J].哈尔滨医科大学学报,2017,51(4):369-371.
[4]尹娟,何颖瑶,郭鹤龄.扁桃体Ⅰ度阻塞性睡眠呼吸暂停低通气综合征患儿不同等离子术式远期疗效[J].山东大学耳鼻喉眼学报,2017,31(3):87-90.
[5]中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].柳州医学,2012,35(3):162-165.
[6]任小东,蒋晓平,陈天宾,等.鼻内窥镜下低温等离子射频消融术与扁桃体联合腺样体切除术治疗小儿鼾症伴过敏性鼻炎疗效比较[J].现代中西医结合杂志,2017,26(9):928-931.
[7]金书香,王吉喆,曲慧.腺样体、扁桃体切除术对OSAHS患儿免疫功能的影响[J].临床耳鼻咽喉头颈外科杂志,2017,31(23):1810-1814.
[8]杨东宝,乔富玉,肖静.低温等离子法与传统手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征比较[J].现代仪器与医疗,2017,23(4):60-61.
[9]李达,刘玉欣,于海玲,等.儿童扁桃体及腺样体低温等离子切除术后出血的观察[J].齐鲁医学杂志,2017,32(4):444-446.
[10]杨东宝,肖静,徐海蓉.小儿鼾症治疗中内镜下低温等离子射频消融术与电刀凝切术的应用分析[J].中国妇幼健康研究,2017,28(S1):399-400.
[11]仇书要,刘大波,钟建文,等.儿童腺样体及扁桃体低温等离子消融术后腭瘘一例[J].中华耳鼻咽喉头颈外科杂志,2017,52(2):113-114.
[12]徐烨星,陈金辉,章薇,等.等离子刀扁桃体部分切除术联合腺样体射频消融术治疗儿童鼾症的短期疗效研究[J].现代生物医学进展,2017,17(6):1048-1052.
[13]李燕.腭咽成形术与低温等离子消融术治疗小儿鼾症的临床疗效分析[J].中南医学科学杂志,2017,45(6):637-640.