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

目的 探讨儿童扁桃体Ⅰ度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)低温等离子腺样体消融术与扁桃体+腺样体消融术远期疗效及影响因素。 方法 收集119例扁桃体Ⅰ度OSAHS患儿完整的临床资料,其中,实验组(60例)接受低温等离子扁桃体切除+腺样体消融术,对照组(59例)接受低温等离子腺样体消融术。通过术后6个月、1年、2年及4年的随访,比较两组患儿术后疗效及生活质量。 结果 术后4年,实验组治愈53例,好转4例,无效3例,总有效率95%;对照组治愈25例,好转24例,无效10例,总有效率83.05%。实验组患儿疗效明显优于对照组,差异具有统计学意义(P<0.1)。术后疗效的影响因素有年龄、肥胖、合并有鼻-鼻窦炎、中耳炎、合并牙颌面畸形等。实验组中远期并发症咽部异物感2例。 结论 低温等离子切除肥大的腺样体及扁桃体是治疗扁桃体Ⅰ度OSAHS患儿的有效方法。

Analysis of the long-term clinical effects of different plasma operations on obstructive sleep apnea hypopnea syn- drome in children with grade 1 tonsils

Objective To analyze the long-term efficacy and factors influencing clinical outcomes of adenoidectomy and tonsillectomy using ablation in pediatric patients with grade 1 tonsils and obstructive sleep apnea hypopnea syndrome (OSA HS).Methods Clinical data of 119 children with grade 1 tonsils and obstructive sleep apnea hypopnea syn-drome (OSA HS)were collected.Children were treated using different surgeries between January and December 2012, and the surgical outcomes were retrospectively analyzed.Patients in the experimental group (60 cases)were treated with adenoidectomy and tonsillectomy with ablation;patients in the control group (59 cases)were treated with adenoid-ectomy ablation.Postoperative efficacy and quality of life of the two groups were compared after 6 months and 1,2, and 4 years.Results Four years after surgery,in the experimental group,53 patients were cured,4 showed improve-ment,and 3 had experienced no effect;the total effective rate was 95%.In the control group,25 patients were cured, 24 showed improvement,and 10 were invalid;the total effective rate was 83.05%.The effective rate of the experimen-tal treatment was statistically superior to the effective rate of the control treatment (P<0.1 ).The factors influencing clinical outcomes included age,obesity,rhinitis and nasosinusitis,otitis media,and dento-maxillofacial deformities. The long-term complications included two cases of pharyngeal foreign body in the experimental group.Conclusion Adenoidectomy and tonsillectomy with ablation is an effective method for treatment of children with OSA HS with grade 1 tonsils.