鼻内镜下吸切器治疗小儿腺样体肥大的疗效观察

目的探讨鼻内镜下吸切器治疗小儿腺样体肥大的疗效和安全性。方法对63例4～12岁腺样体肥大的患儿行鼻内镜下吸切器吸切治疗,所有病例鼻咽侧位片示腺样体厚度/鼻咽腔前后径≥0.71,纤维鼻咽镜检查腺样体阻塞后鼻孔的程度Ⅲ°52例;Ⅳ°11例。其中以鼻塞、流涕首诊15例,睡眠打鼾、憋气、张口呼吸39例,听力下降9例。11例并发扁桃体Ⅲ°,肥大者予以切除,3例鼓室积液同期行鼓膜置管术。结果 9例伴分泌性中耳炎复查声导抗鼓室功能曲线均呈A型,语频听力恢复到发病前水平,12例鼻腔通气正常,3例明显改善,37例睡眠打鼾和张口呼吸症状消失,2例好转。全部患儿术后无大出血、无鼻咽粘连和损伤等症状。结论手术是治疗临床症状明显的腺样体肥大的较好手段,鼻内镜下吸切器行腺样体切除与传统方法相比具有视野清晰、创伤小、出血少、不易残留、治疗效果好等优点,可以推广。

Observation on the Efficacy of Nasal Endoscopy-assisted Treatment of Adenoidal Hypertrophy in Children

Objective To discuss the efficacy and safety of nasal endoscopy-assisted treatment of adenoidal hypertrophy in children.Methods 63 patients aged 4 to 12 years old,diagnosed with adenoidal hypertrophy in children were treated by nasal endoscopy-assisted sucking and cutting.All cases′ nasopharyngeal cavity diameters were greater than or equal to 0.71.Fiber endoscope checking the nostril degree after adenoid obstruction:Ⅲ°52 cases,Ⅳ°11 cases.Among these cases,nasal obstruction,rhinorrhea were first diagnosed in 15 cases.Sleep snoring,mouth breathing,breath occurred in 39 cases and hearing loss in 9 cases.11 patients with Ⅲ° hypertrophy of the tonsils,their tonsil were removed.At the same time,3 patients with middle ear effusion were operated by grommet insertion.Results 9 patients with secretory otitis media review of acoustic immittance tympanometry function curves were type A,their speech frequency hearing recovered to premorbid levels.12 patients′ nasal ventilation were in normal status,3 cases were improved significantly.Sleep snoring and mouth breathing symptoms disappeared in 37 cases,2 cases were improved.All patients had no symptoms such as postoperative bleeding,nasopharyngeal adherence or injury.Conclusion Operation is a good method to treat clinical symptoms of adenoidal hypertrophy.Compared with the traditional method,nasal endoscopy-assisted adenoidectomy resection has many advantages such as clear vision,small wound,less bleeding,rare residue,good treatment effect and so on,which can be promoted.