低温等离子射频扁桃体部分切除术及全切术治疗儿童OSAHS的疗效比较

Partial tonsillectomy vs tonsillectomy with coblation in children with obstructive sleep apnea hypopnea syndrome

目的:比较低温等离子射频扁桃体部分切除术及全切术治疗OSAHS的短期疗效差异。方法:将并发扁桃体肥大的160例OSAHS患儿随机分为2组:实验组行腺样体切除联合扁桃体部分切除术,对照组行扁桃体全切术;对术前术后的睡眠监测结果、疼痛评分、术后并发症等进行比较。结果:实验组和对照组术后1周和术后3个月的睡眠监测结果较术前均有明显改善,且2组之间各项指标术后同期比较差异无统计学意义。术后4d实验组较对照组疼痛评分较低,差异有统计学意义,术后5～10d疼痛差异无统计学意义。2组患儿创面假膜脱落时间差异无统计学意义,对照组有8例术后1周内继发出血,16例术后半年舌根及咽后壁淋巴组织代偿性增生,而实验组无类似并发症发生。结论:低温等离子射频扁桃体部分切除具有出血少、术后睡眠呼吸阻塞症状改善明显、术区疼痛反应较轻、可保留原有扁桃体的生理功能等特点,适用于各年龄段扁桃体为增生肥大病变的OSAHS患儿。

Objective：To investigate the difference of therapeutic effects between coblation treatment of partial tonsillectomy and bolo-tonsillectomy in children with obstructive sleep apnea-hypopnea syndrome. Method： One hundred and sixty children with obstructive sleep apnea-hypopnea syndrome were divided randomly into two groups as experimental group（coblation treatment of partial tonsillectomy） and control group （bolo-tonsillecto- my）. The sleep Monitoring results, pain scores and therapeutic effects were evaluated. Result： After operation 1 week and 3 months, the sleep Monitoring results were improved remarkably both in experimental group and con- trol group. But there were no significant differences in the sleep Monitoring results between the experimental group and control group after operation. The pain scores were lower in experimental group than control group within 4 days after operation. There were no significant differences of pain scores between the experimental group and control group above 5 days after operation. There were no significant differences in the time of pseudomem- brane ablate. In control group, 8 patients occurred Secondarily bleeding within 1 week and 16 patients lymphatic tissue hyperplasia compensatorily within half a year after operation. There was no similar complication occurred in experimental group. Coneluslon：Coblation treatment of partial tonsillectomy in children with obstructive sleep ap- nea-hypopnea syndrome can reduce bleeding volume, improve obstruct syndrome apparently, relieve pain and re- serve function of Tonsil. It is suitable for children of different age groups with hypertrophy of tonsils.