经口-鼻内窥镜下腺样体吸切术在治疗儿童阻塞性睡眠呼吸暂停低通气综合征中的应用

目的：探讨经口-鼻内窥镜下腺样体吸切术在治疗患有阻塞性睡眠呼吸暂停低通气综合征（OSAHS）儿童患者手术中的应用。方法：对经睡眠监测诊断为OSAHS的48例儿童，同时行头颅侧位X光片或鼻咽纤维镜检查确定腺样体肥大程度，采用气管插管全麻行扁桃体剥离加经口－鼻内窥镜引导下腺样体吸切术。结果：所有患儿术后睡眠呼吸通畅，夜间憋醒消失，打鼾明显减轻或消失，无术后大出血，随访3～6个月，无鼻咽闭锁、咽鼓管瘢痕等并发症。结论：扁桃体剥离加经口-鼻内窥镜引导下腺样体吸切术治疗OSAHS患儿可缓解病情，减少手术并发症。

Exsecting adenoid by nasal endoscope via mouth for pediatric obstructive sleep apnea hypopnea syndrome

To explore the surgical treatment and effect for pediatric obstructive sleep apnea hypopnea syndrome(OSAHS). Methods: Forty eight children, 3 14 years old with OSAHS received the cranial position X ray examination which presented adenoid hypertrophy. Then tonsillectomy + adenoidectomy was performed on by nasal endoscope through orapharynx. Results： After operation, the respiration blockade and sleep suppress disappeared and the snoring condition relieved, and no postoperative bleeding was presented. After 3 to 6 month follow up, there was no complication of postoperative nasopharyngeal atresia and nasopharyngeal stenosis. Conclusion： Pediatric OSAHS is mainly due to tonsi1 and adenoid hypertrophy and is sufficiently remitted by endoscopic tonsillectomy or/and adenoidectomy through orapharynx.