儿童阻塞性睡眠呼吸暂停低通气综合征104例

Obstructive sleep apnea hypopnea syndrome in 104 children

目的探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的临床诊断标准和采用等离子低温切除扁桃体及鼻内镜下低温消融腺样体治疗儿童OSAHS的疗效。方法通过临床症状、常规检查、鼻咽镜检查及鼻咽侧位X线片和多导睡眠监测确诊的OSAHS患儿104例。所有患儿均在气管插管全身麻醉下,采用美国低温等离子手术系统切除双侧扁桃体、鼻内镜下消融腺样体,其中手术切除双侧扁桃体22例,消融腺样体28例,切除扁桃体加消融腺样体54例。结果104例患儿经治疗后,治愈74例,显效22例,有效6例,无效2例。无一例出现手术并发症。结论临床表现、常规检查、鼻咽镜及影像学检查结合多导睡眠监测为诊断儿童OSAHS的依据。通过等离子扁桃体切除、腺样体消融解除上气道阻塞,是目前治疗儿童OSAHS的最佳选择。

Objective To explore the diagnosis of obstructive sleep apnea hypopnea syndrom（OSAHS） in children and to investigate the therapeutic effect of plasma low temperature tonsillectomy and adenoidectomy at low temperature on OSAHS. Methods One hundred and four pediatric patients were diagnosed as OSAHS by clinical manifestation, routine examination, fibrorhinopharyngescopy, X-ray at lateral rhinopharyngeal view and overnight polysomnography （PSG）. Adenoidectomy and tonsillectomy was performed in 54 patients, only adenoidectomy in 28 cases and only tonsillectomy in 22 cases. Results Seventy four patients were cured, with 22 cases being improved evidently, 6 cases being effective and 2 cases being ineffective. Conclusions Clinical symptoms and signs, X-ray at lateral rhinopharyngeal view, overnight PSG and so on were the major indexes for the diagnosis of OSAHS. Surgery was the best method for the treatment of OSAHS. （Chin J Ophthalmol and Otorhinolaryngo1,2010,10：95-96）