扁桃体和腺样体切除术治疗小儿鼾症的疗效观察

The Clinical Effect Observation of Tonsillectomy and Adenoidectomy in Treatment of Children with Sleep Apnea

目的:研究扁桃体和腺样体切除术治疗小儿鼾症的临床疗效。方法:选取本院2010年10月-2013年5月收治的120例扁桃体肥大合并腺样体肥大患儿。其中60例行传统方法即扁桃体切除加腺样体刮除术治疗,标记为对照组;另外60例运用扁桃体摘除加鼻内镜下腺样体刮除术治疗,标记为治疗组,比较两组的疗效、手术情况和腺样体残留率。结果:两组疗效比较差异无统计学意义(P>0.05)。对照组手术时间为(10.1±2.9)min,术中出血量为(72.0±3.6)mL,治疗组手术时间为(8.9±2.6)min,术中出血量为(58.0±3.2)mL,治疗组手术时间和术中出血量均优于对照组,两组比较差异均有统计学意义(P<0.05)。对照组腺样体残留率为36.2%,治疗组为14.9%,两组比较差异有统计学意义(字2=5.98,P<0.05)。结论:这两种方法的近期疗效相似,但是扁桃体摘除加鼻内镜下腺样体刮除术创口小,出血量少,腺样体残留率低,远期疗效优于传统方法,值得推广应用。

Objective：To study the clinical effect of tonsillectomy and adenoidectomy in treatment of children with sleep apnea. Method：One hundred and twenty children with hypertrophy of tonsil and adenoid in the hospital from October 2010 to May 2013 were chosen. Sixty cases were given conventional method as tonsillectomy and adenoidectomy and marked as control group. The other 60 cases were given tonsillectomy and adenoidectomy under nasal endoscope and marked as treatment group. Clinical effect,surgical conditions and residual rate of adenoid of both groups were compared after treatment. Result：There was no significant difference of the clinical effects between the two groups（P〉0.05）. Operation time of the control group was（10.1±2.9）min and bleeding amount was（72.0±3.6）mL,while the treatment group was（8.9±2.6）min and（58.0±3.2）mL,which were all obviously better than the control group（P〈0.05）. Residual rate of adenoid of the control group was 36.2%,while treatment group was 14.9%,which was obviously better than the control group（X2=5.98,P〈0.05）. Conclusion：Short-term clinical effects of the two kinds of methods is alike,but tonsillectomy and adenoidectomy under nasal endoscope has advantages like smaller cut,less bleeding amount and lower rate of residual adenoid. It’s long-term clinical effect is superior to conventional method and it should be popularized in clinical work.