鼻内镜下低温等离子射频消融治疗儿童腺样体肥大的临床研究

目的：探讨鼻内镜下经口低温等离子射频消融治疗儿童腺样体肥大的临床疗效。方法回顾性分析98例患腺样体肥大的儿童对于不同治疗手段的疗效情况，分为试验组50例和对照组48例，其中试验组给予鼻内镜下低温等离子射频消融术，对照组给予传统腺样体刮除术，并分析比较两组患儿的手术时间、术中出血量及住院时间，并随访1年，比较观察患儿的鼻塞、打鼾和听力等临床症状，以及患儿术后残留、复发及并发症发生情况。结果与对照组比较，试验组的术中出血量明显低于对照组，且差异有统计学意义（P＜0.05）；试验组术后鼻塞、打鼾和听力等临床总有效率分别为86.0％（43/50）、80.0％（40/50）、76.0％（38/50），明显高于对照组的68.8％（33/48）、60.4％（29/48）、54.2％（26/48），差异有统计学意义（P＜0.05）；试验组术后仅1（2.0%）例腺样体残留，且未见腺样体肥大复发，对照组术后腺样体残留率58.3％（28/48），腺样体肥大复发率16.7％（8/48），两组比较差异有统计学意义（P＜0.05），且两组术后均未见严重并发症发生。此外，对两组进行未复发率分析及Log-rank检验，差异有显著性意义（P＜0.05）。结论鼻内镜下低温等离子射频消融治疗儿童腺样体肥大临床疗效好，术中出血量少，术后无复发和其他并发症发生，可作为手术治疗儿童腺样体肥大的首选方法。

The clinical research on the treatment of the low temperature plasma radiofrequency ablation through the mouth under endoscope in adenoid hypertrophy of children

Objective To investigate the low temperature plasma radiofrequency ablation through the mouth under endoscope clinical curative effect for the treatment of adenoid hypertrophy in children. Methods A retrospective analysis of 98 cases of children with adenoid hypertrophy were to the curative effect of different treatments, 50 cases were divided into test group and control group, 48 cases of experimental group gives the low-temperature plasma radiofrequency ablation under endoscope, the control group given conventional adenoidectomy curettage, and analysis and comparison of two groups of children with operation time, intraoperative blood loss and length of hospital stay, and followed up for 1 year, compared to observe the patient＇s clinical symptoms such as nasal congestion, snoring and hearing, and postoperative residue, recurrence and complications. Results Compared with control group, experimental intraoperatie blood loss is lower than the control group significantly, and the difference was statistically significant （P 〈 0.05）; Patients postoperative nasal congestion, snoring and hearing the clinical total effective rate was 86.0%（43/50）, 80.0%（40/50）, 76.0%（38/50）, significantly higher than the control group 68.8%（33/48）, 60.4%（29/48）, 54.2%（26/48）, the difference was statistically significant （P〈0.05）;Patients postoperative only 1 （2.0%） cases of adenoid residual body, and no recurrence of adenoid hypertrophy, the control group after adenoidectomy residual rate is 58.3%（28/48）, recurrent adenoid hypertrophy were 16.7%（8/48）, is similar between the two groups have statistical significance （P〈0.05）, and two groups there were no serious postoperative complications. In addition, the two groups were no recurrence rate analysis and Log-rank test, there were significant differences （P〈0.05）. Conclusion Nasal endoscopic low-temperature plasma radiofrequency ablation in the treatment of adenoid hypertrophy in children good clinical curative effect, less intr