低温射频消融治疗儿童阻塞性睡眠呼吸暂停低通气综合征

The Application of Temperature-Controlled Radiofrequency Ablation in Children Obstructive Sleep Apnea Hypopnea Syndrome

目的 探讨低温射频消融双侧扁桃体对儿童阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）的治疗作用. 方法 2003年1月～2006年1月,30例经多导睡眠监测（polysomnography,PSG）证实的儿童OSAHS,年龄3～10岁,平均5.8岁,均行双侧扁桃体低温等离子刀消融术,对21例合并腺样体肥大者同时行腺样体刮除术,其中3例合并分泌性中耳炎行鼓膜穿刺抽液. 结果 术后6个月睡眠打鼾、张口呼吸症状消失,双侧扁桃体Ⅰ～Ⅱ度,咽腔无狭窄,听力恢复正常.20例术后1年PSG示治愈10例,显效8例,有效2例. 结论 低温射频等离子扁桃体消融术治疗儿童OSAHS是有效而且安全的.

Objective To explore the clinical effect of temperature-controlled radiofrequency ablation of tonsil in the treatment of children obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods From January 2003 to January 2006, 30 patients, confirmed OSAHS by polysomnography （PSG） , aging from 3 to 10 years （mean： 5.8 years） were treated by temperaturecontrolled radiofrequency ablation of tonsil, in which 21 cases with adenoidal hypertrophy were treated with adenoidectomy, and 3 of the 21 cases with secretory otitis media received auripuncture. Results Six months after the operation, the symptom of snoring and mouth breathing in all patients disappeared, tonsillar hypertrophy was kept in Ⅰ or Ⅱgrade, no pharynx stenosis was detected, and hearing was recovered to normal. After 1 year, 20 cases were monitored with PSG, of which 10 cases were cured, 8 cases showed apparent efficacy and 2 cases showed efficacy. Conclusions The temperature-controlled radiofrequency ablation of tonsil is an effective and safe technique in the treatment of children OSAHS.