不同手术方式对儿童OSHAS相关指标与通气功能的影响

目的不同手术方式对儿童鼾症(obstructive sleep apnea-hypopnea syndrome,OSHAS)相关指标与通气功能的影响。方法研究对象选取2008年4月~2018年4月期间我院收治的108例OSHAS患儿,患者根据随机数字法被分成观察组与对照组,每组各54例。对照组患儿接受腺样体刮除术以及扁桃体剥离术,观察组接受鼻内窥镜下低温等离子射频消融术。对比和评估两组患儿手术情况、疼痛程度及通气功能。结果手术治疗后,观察组与对照组手术时间(25.11±5.28vs48.43±4.78)min,术中出血量(12.55±2.27vs34.12±3.10)ml,术后疼痛时间(2.40±0.29vs4.60±0.50)d,症状缓解时间(6.90±0.83vs9.80±0.70)d。观察组手术时间、术中出血量、术后疼痛时间、症状缓解时间均明显缩短(P<0.05)。术后6个月观察组与对照组呼吸暂停低通气指数(AHI)(9.38±1.03vs15.78±2.89)h、最长呼吸暂停时间(LAT)(17.65±3.11vs26.21±4.12)s和最低夜间血氧饱和度(LSaO2)(86.43±9.00vs78.47±8.79)s。两组患儿术前各通气功能指标差异无统计学意义(P>0.05),且观察组AHI和LAT等通气功能与对照组相比明显下降(P<0.05),而观察组LSaO2通气指标水平比对照组明显增高(P<0.05)。此外,术后观察组患儿鼻腔干燥、鼻腔出血、萎缩性鼻炎及鼻涕倒流等并发症发生率与对照组相比显著降低(P<0.05)。结论鼻内镜下低温等离子射频消融术可有效改善手术情况,缓解患儿术后疼痛程度,降低患儿术后反应,提高患儿通气功能,安全有效,值得推广。

Effects of different surgical methods on stress index and ventilation function in children with OSHAS

Objective To explore the effects of different surgical methods on stress index and ventilation function in children with OSHAS.Methods 108 cases of OSHAS pediatric patients who were treated in our hospital from April 2008 to April 2018 were selected as the observation subjects,they were divided into the control group and the observation group according to the random number table method,with 54 cases in each group.The control group received adenoidectomy curettage combined with tonsillectomy,and the observation group was treated with nasal endoscopic low temperature plasma radiofrequency ablation.The surgery condition,postoperative pain and ventilation function were compared and analyzed between the two groups.Results After surgical treatment,the operation time,the amount of intraoperative bleeding,postoperative pain time and symptom remission time in the observation group were significantly decreased(P<0.05).6 months after surgery,the Apnea hypopnea Index(9.38±1.03vs15.78±2.89)h,longest apnea times(17.65±3.11vs26.21±4.12)s and the lowest blood Oxygen saturation at night(86.43±9.00vs78.47±8.79)s in the observation group and the control group were recorded.There was no significant difference in preoperative ventilation function between the two groups(P>0.05),and the ventilation function of AHI and LAT in the observation group decreased significantly compared with that in the control group(P<0.05),while the time of LSaO2 ventilation index in the observation group was significantly higher than that in the control group(P<0.05).During the treatment period,the incidence of complications such as nasal dryness,nasal hemorrhage,secretory otitis Media and runny nose reflux in children in postoperative observation group was significantly lower than that in control group(P<0.05).Conclusion Nasal endoscopic low temperature plasma radiofrequency ablation contributes to the improvement of the operation situation,and the treatment can relieve the degree of postoperative pain in children,improve the ventilation function,it is safe and effective,and it is worth promoting.