等离子刀扁桃体部分切除术联合腺样体射频消融术治疗儿童鼾症的短期疗效研究

Research on the Short-term Effect of Partial Tonsillectomy combined Adenoidectomy on Children with Sleep Apnea Syndrome

目的:探讨等离子刀扁桃体部分切除术(Tonsillotomy,TT)联合腺样体射频消融术治疗儿童鼾症的短期临床疗效。方法:选取2015年1月至2016年1月于我院接受扁桃体和腺样体手术的鼾症患儿77例机分为实验组即扁桃体部分切除术组(TT组)和对照组即扁桃体全部切除术(Tonsillectomy,TE)组(TE组)。选用儿童OSA-18生活质量调查表对儿童鼾症患者术前1个月和术后6个月进行调查随访和评估比较两组临床疗效的差异。采用VAS量表计量两组患儿术后1-7天的吞咽疼痛情况。观察两组患儿术后出血、术后扁桃体发炎情况以及扁桃体增生情况。结果:TT组和TE组患儿术后6个月OSA-18量表的总评分及5个维度的总分较术前比较均下降差异均具有统计学意义(P值均等于0.000),但两组术后OSA-18量表的总评分比较差异无统计学意义(P=0.246)。TT组术后第1天至术后第7天的吞咽疼痛VAS评分均较TE组低差异均具有统计学意义(P值均小于0.01)。两组患者术后均无患儿出血、无扁桃体反复发炎以及扁桃体组织增生。结论:等离子刀扁桃体部分切除术联合腺样体射频消融术治疗儿童鼾症短期临床疗效明确术后吞咽疼痛程度轻微、疼痛时间短,短期内无扁桃体增生及反复扁桃体发炎,可作为治疗儿童鼾症的首选术式之一。

Objective：To explore the clinical therapeutic effects of tonsillotomy（TT） combined with adenoids radiofrequency ablation on the childhood patients with snoring.Methods：77 cases of snoring children received tonsil surgery and adenoidectomy from January 2015 to January 2016 in our hospital were selected in the study.All the cases were assigned to the experimental group（TT group）and control group（Tonsillectomy,TE group）.The children OSA-18 quality of life questionnaire was finished for follow-up survey and assessment 1 month prior to the treatment and 6 months after the treatment,respectively.Visual analog scale（VAS） of two groups was used for the statistics of swallowing pain in 1-7 days postoperative.And postoperative bleeding,recurrent inflammation of the tonsils and tonsillar hyperplasia were observed in two groups.Results：The score of five dimensions and the total score of OSA-18 Questionnaire were reduced 6 months after the treatment in both the TT group and the TE group（P〈0.01）,while no statistical significance was found in the difference of the total score（P〉0.05）.Compared with TE group,the VAS scores of swallowing pain in 1-7 days postoperation was lower in TT group（P〈0.01）.No postoperative bleeding,recurrent inflammation of the tonsils and tonsillar hyperplasia was observed in two groups.Conclusion：Coblation treatment of tonsillotomy（TT） combined with adenoids radiofrequency ablation showed clear clinical effect in the treatment of childhood patients with snoring.The postoperative swallowing pain was slightly and short.There was no tonsillar hyperplasia and recurrent inflammation of the tonsils in the short term.The treatment was recommended for children with snoring.