等离子消融扁桃体部分切除术对小儿鼾症的疗效研究

目的:探讨等离子消融扁桃体部分切除术对小几鼾症的治疗效果。方法:对我院2010年3月至2013年3月我院收治的小儿鼾症患儿80例,随机分为实验组(等离子消融手术组)、对照1组(常规剥离手术组)各40例。比较两组手术时间、术中出血、术后疼痛时间、症状缓解时间及术后并发症。术前、术后6月并用多导睡眠监测仪监测患者睡眠呼吸暂停低通气指数、最低血氧饱和度、最长呼吸暂停时间、呼吸暂停次数和低通气次数。结果:实验组手术时间、术中出血量、术后疼痛时间和症状缓解时间较对照组有统计学差异(P<0.05)。实验组术后出血及发热较对照组例数少,出血例教有统计学差异(P<0.05)。PSG监测结果显示,实验组与对照组术前无统计学差异,两组术后6月AHI、LSaO_2、最长呼吸暂停时间、呼吸暂停次数和低通气次数较术前均有统计学差异(P<0.05),实验组术后6月AHI、低通气次数较对照组有统计学差异(P<0.05)。实验组与对照组见术后总有效率差异无统计学意义(P>0.05)。结论:等离子消融扁桃体部分切除术具有微创、出血少、痛苦小等特点,对小儿OSASH有着良好效果,可在临床广泛开展。

Objective： To evaluate clinical efficacy of coblation tonsillotomy in pediatric obstructive sleep apnea hyponea syndrome （OSAHS） patients. Methods： Eighty pediatric OSAHS patients were randomized recruited and divided randomly into coblation tunsillotomy group and traditional tonsillectomy group. Intraoperative time, bleeding lose, postoperative pain time, symptomatic relief time and postoperative complications were compared between the groups. Apnea hypopnea index, lowest saturation, longest apnea time, apnea frequency and low venting frequency were tested by polysomnography（PSG） before operation and 6 months later. Results： Intraoperative time, bleeding lose, postoperative pain time, symptomatic relief time and postoperative bleeding of coblation tonsillotomy group were less than those in traditional tonsillectomy group. Results from PSG showed that apnca hypopnea index, lowest saturation, longest apnea time, apnea frequency and low venting frequency 6 months after operation were different from those before in both groups. And apnea hypopnea index as well as low venting frequency of coblation tonsillotomy group 6 months after operation were lower than these in traditional tonsillectomy group. Conclusion： Coblation tonsillotomy is effective for children suffering from OSASH due to hypertrophic tonsils. It is worth to promotion due to less injure, bleeding and pain.