等离子低温射频治疗儿童阻塞性睡眠呼吸暂停低通气综合征

目的探讨扁桃体、腺样体等离子低温射频切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）的临床疗效。方法分析2005年8月～2007年5月,对43例患有OSAHS儿童在全身麻醉下,采用低温等离子手术系统Evac70刀头施行扁桃体切除术联合腺样体根治性切除术。结果手术时间10～20min,平均16min;术中出血1～10ml,平均3ml。与术前比较,术后6个月行PSG监测呼吸暂停低通气指数（apnea hypopnea index,AHI）明显降低（14.6±4.6）次/hvs（4.2±2.7）次/h,t=8.563,P=0.000];阻塞性呼吸暂停指数（obstructive apnea index,OAI）明显降低（6.9±3.5）次/hvs（3.3±1.4）次/h,t=5.443,P=0.000];最低血氧饱和度显著提高（85.7±4.4）%vs（99.7±0.2）%,t=-6.687,P=0.000]。结论扁桃体、腺样体等离子低温射频切除术是治疗儿童OSAHS一种有效的治疗方法,具有手术时间短,术中出血少,疗效好等优点。

Effect of Plasma mediated Temperature controlled Radiofrequency Ablation on Obstructive Sleep Apnea Hypopnea Syndrome in Children

Objective To evaluate the efficacy of tonsils and adenoid ablation by plasma-mediated temperature-controlled radiofrequency for obstructive sleep apnea hypopnea syndrome （OSAHS） in children. Methods From August 2005 to May 2007, 43 cases with OSAHS received tonsillectomy and adenoid radical resection with EvacTO tool bit using a plasma-mediated temperature- controlled system. The clinical data of the patients were reviewed. Results The mean operation time was 16 minutes, ranged from 10 to 20 minutes. During the operation, the patients had a mean of 3 ml hemorrhage （1 to 10 ml）. Compared with the preoperative examination, the patients showed significantly lowered AHI （ 14.6 ±4.6） times/h vs （4.2 ± 2.7 ） times/h, t = 8. 563, P = 0. 000 ] and OAI （6.9±3.5） times/h vs （3.3 ± 1.4） times/h, t =5.443, P=0.000] and increased minimum blood oxygen saturation （85.7±4.4）% vs （99.7 ±0.2）% , t= -6.687, P =0.000]. Conclusions The ablation of the tonsil and adenoid using plasma-mediated temperature-controlled radiofrequency is effective and safe for children with OSAHS.