低温等离子辅助下儿童腺样体和扁桃体手术临床疗效观察

Clinical effect analysis of adenoidectomy and tonsillectomy assisted with ablation on children

目的：探讨低温等离子系统辅助手术下治疗儿童腺样体、扁桃体疾病的临床疗效。方法：对我院2 089例经低温等离子辅助手术治疗的儿童腺样体、扁桃体手术患者临床资料进行回顾性分析。采用流行病学方法对患者一般资料,手术方式,术前、术后睡眠打鼾及憋气症状评分进行调查和统计。结果：12 089例患者中男女比为2.08∶1,年龄平均（5.87±3.12）岁,其中3～7岁者1 595例（76.35%）。21 445例（69.17%）患者行扁桃体部分切除,剩余部分消融术治疗,465例（22.26%）患者行扁桃体消融术,179例（8.57%）患者行扁桃体切除术。3全部患儿术前、术后睡眠打鼾及憋气评分差异有统计学意义（P〈0.01）;3种不同手术方式的患者进行两两比较,评分差异无统计学意义（P〉0.05）;对术后症状改善不明显者进行统计,发现影响治疗效果的因素依次为变应性鼻炎、慢性扁桃体炎复发、肥胖、圆枕增生、鼻咽粘连。结论：低温等离子辅助技术在治疗儿童腺样体、扁桃体疾病方面具有独到的优势,针对不同儿童腺样体、扁桃体病变采取个性化治疗有助于提高手术疗效,减轻手术痛苦,值得临床推广。

Objective：This study aims to explore the clinical effect of adenoidectomy and tonsillectomy assisted with ablation on children.Method：The investigation took the form of retrospective review of 2 089 cases of children applied with adenoidectomy and tonsillectomy assisted with ablation in our hospital in recent 10 years.We obtained data of these children with epidemiological methods based on analyzing the status of general information and operation selections,and then analyzing the scores of snoring and breath preoperation and postoperation.Result：1General information of 2 089 cases followed with：the ratio of male and female was 2.08∶1,the average onset age was（5.87±3.12）years old,mostly ranged from 3to 7years old,which consists of 76.35%（1595/2089）of the group.2Different surgery methods of tonsil consisted of three groups as：partial resection associate with ablation was69.17%（1445/2089）,ablation alone was 22.26%（465/2089）and partial resection alone was 8.57%（179/2089）of the group.3A high level scores of snoring and breath more frequently found in preoperative cases than in postoperative cases（P〈0.01）.There are no differentiation among the scores of above three groups（P〉0.05）.The postoperative effect evaluation were related to allergic rhinitis,recurrent of tonsillitis,obesity,circular occipital hyperplasia and nasopharyngeal adhesion.Conclusion：The results suggested that surgery assisted with ablation has its advantage in adenoidectomy and tonsillectomy.Individual therapy for different children will improve the curative effect and relieve the pain of operation,thus is worth a wide application.