低温等离子射频消融术治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效观察

目的观察使用低温等离子射频消融技术治疗因扁桃体腺样体肥大所致儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效。方法收集我院2012年4月～2013年6月资料完整的扁桃体腺样体肥大的患儿48例，其中男27例、女21例，年龄4～12岁。患儿全部在全麻下行鼻内镜低温等离子射频消融术治疗。结果所有患儿术后呼吸暂停和通气不足、伴有打鼾、憋气、血氧饱和度下降、白天嗜睡、多动及厌食等症状明显缓解，术后2个月随访行多道睡眠监测（PSG）检查，治愈37例、显效8例、有效2例、无效1例，总有效率99％。呼吸暂停指数（AHI）术前（18．28±7．56）次／h，术后（4．60±2．28）次／h（t=13，46，P〈0．05）；夜间最低血氧饱和度术前（80．20±3．27）％，术后（94．88±1.23）％（t=29．15，P〈0．05），差异有统计学意义。结论采用鼻内镜下低温等离子射频消融术治疗儿童OSAHS疗效显著，具有低温微创、术中出血少、安全性高、操作简单、恢复期短、创面愈合·陕、并发症少、术后疼痛轻微等优点。

Effects of low- temperature plasma Radiofrequency ablation on the children with obstructive sleep apnea hypopnea syndrome

Objective To observe the effect of low- temperature plasma radiofrequency ablation on the children with obstructive sleep apnea hypopnea syndr：om （OSAHS） caused by tonsil and adenoid hypertrophy.Methods 48 cases of tonsil and adenoid hypertrophy in our hospital from April, 2012 to June, 2013 were collected. There were 27 male and 21 female cases among them, whose age ranged from 4 to 12. All the cases were operated with low temperature plasma radio-frequency ablation assisted by nasal endoscope under general anesthesia. Results The symptoms of OSAHS, including hypoventilation, snoring, short of breath, descend of oxygen saturation value, daytime somnolence, restlessness, and anorexia, were alleviated significantly after operation. All the cases were performed PSG by the end of 2 months after operation. The number of cure, excellence, effectiveness, inefficiency were 37, 8, 2, 1 respectively. The total effective rate was 99%. The results compared with preoperative PSG showed significant differences. That was preoperativeAHI （18.28±7.56） times per hour, postoperative AHI （4.60±2.28） times per hour （t=13.46, P〈0.05） , preoperative lowest oxygen saturation value at night （80.20±3.27） %, postoperative （94.88± 1.23） % （t=29.15, P〈 0.05） . Conclusion The effect of low temperature plasma radio- frequency ablation assisted with nasal endoscope to treat children tonsil and adenoid hypertrophy was significant. The advantages are lower temperature, minimal invasion, less bleeding in the operation, higher safety, simpler manipulation, shorter recovery period, rapid wound healing, less complications, slighter postoperative pain.