儿童阻塞性睡眠呼吸暂停低通气综合征手术治疗的探讨

Therapy of operation about obstructive sleep apneahypopnea syndrome in children

目的探讨儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的治疗方法和疗效。方法经鼻咽侧位X线摄片、纤维鼻咽镜检查及多导联睡眠检测确诊的3～13岁OSAHS患儿45例，行扁桃体切除和经口内镜引导下、采用电动吸切割器切除腺样体。并进行术后随访。结果45例患儿术后无出血及急性呼吸道梗阻发生。随访12～18个月，手术后未出现鼻咽闭锁、咽鼓管功能障碍、腺样体残留等并发症。结论手术切除肥大的扁桃体和（或）腺样体是治疗儿童OSAHS有效的手段之一，鼻咽侧位X线摄片、纤维鼻咽镜检查有助于手术适应证的确定。经口70°内镜引导下腺样体切除术有直视下操作，视野清晰，切除彻底，可避免损伤周围重要结构的特点。

Objective To study the method of therapy and curative effect observation about obstructive sleep apneahypopnea syndrome in children. Methods 45 cases with obstructive sleep apneahypopnea syndrorne（OSAHS） who were between 3 and 13 years were confirmed with nasopharynx radioactive ray lateral position photographs, na- sopharyngo-fiberoseope, full-night polysomnography. After all of the tonsils were removed, their adenoid were ablated with electro-cutterbar through endoscope. All of them were follow up after postoperation. Results All of them,45 cases had no bleeding,acute respiratory tract obstruction after postoperation, followed up for about 12 to 18 months, they all had no complication such as nasopharynx elausura,eustachian tube function disturbance,adenoid residual and so on. Conclusions Hypertrophic tonsil and adenoid exairesis is one of effective therapy ways about OSAHS in children. It is useful for the nasopharynx radioactive ray lateral position photographs and nasopharyngo-fiberoscope to definite the operation indication. The orthophoria performance of adenoidectomy with endoscope through mouth has features such as clear field of vision, thoroughly ablation,avoiding important surrounding structural damage.