低温等离子射频扁桃体及腺样体切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征的疗效(1)

http://www.100md.com 2019年9月5日 《中国现代医生》 2019年第25期

     [摘要] 目的 探討低温等离子射频扁桃体及腺样体切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效及其手术安全性，为患者的诊疗提供指导。 方法 选取2016年4月～2018年6月在我院进行治疗的280例阻塞性睡眠呼吸暂停低通气综合征患儿作为研究对象，按照治疗方式的不同，分为观察组(140例)和对照组(140例)。对照组给予鼻喷激素、孟鲁司特钠咀嚼片等药物治疗，观察组采用低温等离子射频扁桃体切除和(或)腺样体切除术。治疗完成3个月后，比较两种治疗模式的治疗效果，分别对观察组和对照组的阻塞性睡眠呼吸暂停-18(OSA-18)评分、呼吸暂停低通气指数(AHI)以及最低血氧饱和度(LSaO2)进行检测比较。 结果 观察组治疗的总有效率明显高于对照组，两组比较有统计学意义(χ2=12.12，P=0.00)。治疗后，观察组AHI指数、OSA-18评分均明显低于对照组，LSaO2高于对照组，差异有统计学意义(P<0.05)。对照组出现3例呼吸道感染患儿，不良反应率为2.14%;观察组出现2例呼吸道感染患儿，不良反应率为1.43%，两组不良反应率比较差异无统计学意义(χ2=0.210，P>0.05)。 结论 低温等离子射频扁桃体切除和腺样体切除术治疗OSAHS的疗效显著，未见明显不良反应，治疗效果较为理想，在临床治疗上值得推广。

    [关键词] 扁桃体;腺样体;低温等离子;阻塞性睡眠呼吸暂停低通气综合征;儿童

    [中图分类号] R766 [文献标识码] B [文章编号] 1673-9701(2019)25-0028-04

    Therapeutic effect of low temperature plasma radiofrequency for tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea hypopnea syndrome

    WANG Shuzhen GUO Liangrong WANG Dan DUAN Xing ZHANG Xiuju YAO Yuan TIAN Yongsheng

    E.N.T. Department， Aerospace Center Hospital， Beijing 100049， China

    [Abstract] Objective To investigate the clinical efficacy and surgical safety of low-temperature plasma radiofrequency for tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea hypopnea syndrome(OSAHS)， and to provide guidance for patients' diagnosis and treatment. Methods A total of 280 children patients with obstructive sleep apnea hypopnea syndrome who were treated in our hospital from April 2016 to June 2018 were selected. According to different treatment methods， they were divided into observation group(140 cases) and control group(140 cases). The control group was given nasal spray of hormones， montelukast sodium chewable tablets and other medications for treatment. The observation group was given low-temperature plasma radiofrequency for tonsillectomy and/or adenoidectomy. After 3 months of treatment， the therapeutic effects of the two treatment modes were compared. Obstructive sleep apnea-18(OSA-18) score， apnea hypopnea index(AHI)， and minimum oxygen saturation(LSaO2) were detected and compared between the observation group and the control group. Results The total effective rate in the observation group was significantly higher than that in the control group， and the differences between the two groups were statistically significant(χ2=12.12， P=0.00). After treatment， the AHI index and OSA-18 score in the observation group were significantly lower than those in the control group， and the LSaO2 was higher than that in the control group. The differences were statistically significant(P<0.05). There were 3 children patients with respiratory infection in the control group， and the adverse reaction rate was 2.14%; there were 2 children patients with respiratory infection in the observation group， and the adverse reaction rate was 1.43%. There was no statistically significant difference in the adverse reaction rates between the two groups(χ2=0.210， P>0.05). Conclusion Low-temperature plasma radiofrequency for tonsillectomy and adenoidectomy in the treatment of OSAHS has a significant efficacy， and no obvious adverse reactions have been observed. The therapeutic effect is ideal and this method is worthy of promotion in clinical treatment.(王淑珍 郭良蓉 王丹 段星 张秀菊 姚远 田永胜)

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