鼻内镜下腺样体低温等离子消融术和动力切割术的疗效比较

The Clinical Observation of Coblation-assisted adenoidectomy and nasal dynamical system-assisted adenoidectomy for Treatment of Children with Obstructive Sleep Apnea Hypopnea Syndrome

目的：分别通过低温等离子射频消融和鼻动力切割进行腺样体切除，观察两种手术方式的手术时间、出血量及疗效，分析两种手术方式的优缺点。方法收集2008年1月～2011年12月我院收治的儿童阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）中，扁桃体和/或腺样体肥大的患儿共75例，其中30例行鼻动力切割腺样体切除术，45例行低温等离子射频消融腺样体切除术，统计两种术式的手术时间、出血量及术后半年疗效（儿童OSAHS疾病特异性生活质量调查（OSA-18））评估有无差异。结果鼻动力切割组与等离子消融组比较，两者切除腺样体手术时间差异无统计学意义，但是鼻动力切割组出血量明显多于等离子消融组，差异有统计学意义（P〈0.05），两者手术方式对儿童阻塞性睡眠呼吸暂停低通气综合征都有治疗效果。结论两种术式术后都能改善患儿的生活质量，疗效满意；鼻内镜下等离子低温射频消融腺样体切除术较鼻动力切割手术出血明显减少，值得推广。

Objective To investigate the clinical efficacy and safety of the adenoidectomy assisted by the coblation-assisted or the nasal dynamical system for the children with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods From January 2008 to December 2011, the adenoidectomy had been done assisted by ENT Coblator surgical instrument or nasal dynamical system for 75 children, aged 3 to 13 years old. The follow-ups were conducted by telephone interview and the follow up time was 6 months after the operation. The responses were recorded on a standardized questionnaire （pediatric OSAHS disease-specific quality of life survey （OSA-18））.Results here was no significant difference in the operation times between two groups and the amount of bleeding of the adenoidectomy assisted by the nasal dynamical system was more than those of the coblation. Both ways decrease the scores of the OSA-18 in patients statistically after 6 months.ConclusionThe adenoidectomy assisted by the coblation-assisted or the nasal dynamical system both had good clinical efficacy and can be especially suitable for surgical treatment of children with OSAHS.