扁桃体腺样体切除术治疗阻塞性睡眠呼吸暂停综合征患儿的疗效观察

目的 探讨扁桃体腺样体切除术对阻塞性睡眠呼吸暂停综合征（OSAS）患儿的治疗效果。方法 多导睡眠检测(PSG)确诊OSAS患儿60例。随机分为实验组A组（30例）、对照组B组（30例）。A组住院行扁桃体腺样体切除术，B组给予口服安慰剂维生素C（剂量均为0.1mg），比较A组与B组治疗前及治疗3个月后的呼吸暂停低通气指数（AHI）及最低动脉血氧饱和度（SaO2）的变化，同时对比两组患儿家长的语言评价量表(VRS)评价结果的差异。结果 治疗前A组及B组的AHI和最低SaO2无明显差异。治疗3个月后A组AHI为2.6±1.8、最低SaO2为92.9±2.5与B组相应的AHI为17.1±8.2、最低SaO2为81.4±9.1差异明显，差异有统计学意义。另外，根据患儿家长的语言评价量表评价结果，实验组OSAS患儿睡眠打鼾、憋气及张口呼吸症状改善有效率分别为86.7％、93.3％、86.7％，明显高于对照组( 6.7%、13.3%、13.3%)。结论 腺样体和扁桃体术对儿童OSAS有较好的疗效，是治疗儿童OSAS的有效方法。

Efficacy of adenoidectomy and tonsillectomy for the children with obstructive sleep apnea syndrome

Objective To observe the efficacy of adenoidectomy and tonsillectomy in children with obstructive sleep apnea syndrome (OSAS). Methods Sixty children with OSAS were selected after a PSG(polysomnography) test. The children were randomily divided into group A (30 cases) or group B ( 30 cases). In group A, adenoids and/or tonsils were ablated, while vitamin C (0.1mg) was administered orally in group B. Apnea-hypopnea index (AHI) and lowest blood oxygen saturation (SaO2), before and after 3 month treatment in the two groups, were tested. Clinical outcomes, in light of the language evaluation form（VRS）furnished by the parents, were also compared. Results No obvious difference of AHI and the lowest SaO2 before the treatment was found between the groups. However, after three months of treatment, AHI reduced to 2.6±1.8, and the lowest SaO2 increased to 92.9±2.5 in group A, in which all improved significantly compared with those before the treatment (P＜0.05). Also, AHI and lowest SaO2 in group B did not significantly change after the therapy (from 18.4±7.8 to 17.1 ±8.2, 79.2 ±11.4 to 81.4±9.1, respectively). According to the clinical outcomes, 86.7%, 93.3% and 86.7% of the children in group A improved in snore, and suffocation or mouth breathing which were all better than those in group B (6.7%,13.3%, and 13.3%,respectively;all P＜0.05). Conclusion Adenoidectomy and tonsillectomy are effective procedures to treat OSAS in children.