儿童阻塞性睡眠呼吸暂停的手术方式及疗效分析

【目的】分析不同手术方式治疗儿童阻塞性睡眠呼吸暂停的疗效。【方法】对扁桃体肥大及腺样体肥大所致阻塞性睡眠呼吸暂停的儿童，采用传统腺样体刮除＋单侧扁桃体切除（A组）及鼻内镜引导下腺样体切割＋双扁桃体切除术（B组），术后随访并分析疗效。【结果】A组治疗28例：治愈15例，好转8例，无效5例，有效率82．1％；B组治疗65例：治愈52例，好转13例，有效率100％。【结论】儿童阻塞性睡眠呼吸暂停主要是解除鼻咽及口咽气道的阻塞，才能保证气道通畅，鼻内镜引导下腺样体切割＋双扁桃体切除能很好地解决鼻咽，口咽气道阻塞，疗效最好。

Approach and Efficacy of Surgery for Obstructive Sleep Apnea in Children

Objective]To retrospectively analyze and compare the efficacy of traditional adenoidectomy plus unilateral tonsillectomy（A group） and endoscopic adenoidectorny plus bilateral tonsillectorny（B group） for the treatment of obstructive sleep apnea in children. Methods]The children with obstructive sleep apnea in- duced by tonsillar and adenoid hypertrophy were treated with traditional adenoideetorny plus unilateral tonsillectomy and endoscopic adenoidectomy plus bilateral tonsillectomy, respectively. All patients were followed up and the therapeutic effect was analyzed. Results]In A group, 28 children were treated with traditional adenoidectomy plus unilateral tonsillectomy. Among them, 15 were cured, 8 were improved and 5 were not cured. The effective rate in A group was 82.1%. In B group, 65 children were treated endoscopic adenoidectomy plus bilateral tonsillectomy. Among them, 52 were cured and 13 were improved. The effective rate in B group was 100 %. Conclusion]The children with obstructive sleep apnea mainly should be treated by relieving the obstruction of rhinopharynx and mesopharynx in order to keep the airway unobstructed. Therefore, endo- scopic adenoidectomy plus bilateral tonsillectomy can resolve the airway obstruction of rhinopharynx and meso- pharynx, and has the best efficacy.