激光辅助下扁桃体和(或)腺样体部分切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效观察

Laser-assisted Tonsillotomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea/hypopnea Syndrome

目的探讨钇铝石榴石(Nd:YAG)激光辅助下扁桃体和(或)腺样体部分切除术对儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的治疗效果。方法 125例OSAHS的患儿行Nd:YAG激光辅助下扁桃体和(或)腺样体部分切除术,术前和术后进行OSAHS疾病特异性生活质量调查(OSA-18)、采用脉搏传导时间(PTT)便携式监测仪监测睡眠。结果 OSAHS患儿术后睡眠障碍问题OSAHS程度分度中度和重度、身体状况问题中度和重度、对监护人的影响中度和重度较术前明显降低,差异有统计学意义(P<0.05)。术后OSA-18总分较术前明显较低,差异有统计学意义(P<0.05)。OSAHS患儿术后呼吸暂停低通气指数、呼吸暂停指数、低通气指数及与呼吸事件相关微觉醒指数较术前明显降低,差异有统计学意义(P<0.05);OSAHS患儿术后最低血氧饱和度较术前明显升高,差异有统计学意义(P<0.05)。结论 Nd:YAG激光辅助下扁桃体和(或)腺样体部分切除术能够改善中重度儿童OSAHS的生活质量,纠正轻度患儿睡眠症状,是治疗儿童OSAHS的有效方法。

Objective To evaluate the effect of YAG-laser-assisted tonsillotomy and adenoidectomy on pediatric obstructive sleep apnea/hypopnea syndrome（OSAHS）.Methods One hundred twenty-five OSAHS children were given YAG-laser-assisted tonsillotomy and adenoidectomy.The survey of OSAHS specific quality of life（QOL）（OSA-18） was performed and sleep monitored by pulse transmit time（PTT） ambulatory monitor before and after treatment.Results Moderate and severe sleep disorders,moderate and severe health problems,moderate and severe effect on guardians,and OSA-18 total scores were significantly were is lower after treatment than before（P0.05）,and apnea/hypopnea index（AHI）,apnea index,hypopnea index and respiratory event-related microarousal index lower（P0.05）,but minimum blood oxygen saturation higher（P0.05）.Conclusion YAG-laser-assisted tonsillotomy and adenoidectomy,which can improve the QOL of children with moderate or severe OSAHS and correct mild sleep symptoms,is an effective method for pediatric OSAHS.