内镜技术在儿童OSAHS诊治中的应用

Application of Endoscopic Technique in the Diagnosis and Treatment of OSAHS in Children

目的探讨内镜技术在儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的诊断价值。方法选取我院2015年12月31日到2016年12月31日收治的阻塞性睡眠呼吸暂停低通气综合征患儿40例作为研究对象,将合并有分泌性中耳炎患儿设为A组(20例),无合并分泌性中耳炎患儿设为B组(20例)。采用模拟内镜技术对两组患儿进行鼻咽部检查,观察比较两组患儿的腺样体最突出部位的厚度、鼻咽腔前后径等。结果 A组的腺样体厚度为(15.24±3.25)mm,B组为(15.87±5.21)mm,组间无统计学差异(P>0.05);A组的鼻咽腔前后径为(19.06±4.01)mm,B组为(18.98±5.64)mm,组间无统计学差异(P>0.05);A组的腺样体厚度/鼻咽腔前后径为0.79±0.25,B组为0.81±0.31,组间无统计学差异(P>0.05);A组的腺样体外侧沟深度为(1.59±0.54)mm,显著低于B组的(2.84±2.01)mm,组间差异有统计学意义(P<0.05)。结论模拟内镜技术可以准确地测量腺样体厚度和鼻咽腔隙内有效通气空间的大小,评估腺样体的形态,对诊断儿童阻塞性睡眠呼吸暂停低通气综合征具有重要意义,值得临床推广应用。

Objective To explore the diagnostic value of endoscopic technique for obstructive sleep apnea-hypopnea syndrome （OSAHS） in children. Methods 40 cases of children with OSAHS admitted to our hospital from December 31, 2015 to December 31, 2016 were selected as research objects, among them, 20 cases complicated with secretory otitis media were set as group A, and the other 20 cases were set as group B. Virtual endoscopic technique was used to check the nasopharynx of children, and the thickness of the most prominent part of adenoids and anteroposterior diameter of nasopharyngeal cavity were observed and compared between two groups. Results The thickness of adenoids was （15.24 ± 3.25） mm in group A, and （15.87 ± 5.21） mm in group B, with no statistical difference （P〉0.05）. The anteroposterior diameter ofnasopharyngeal cavity was （19.06± 4.01） mm in group A, and （18.98 ±5.64） mm in group B, with no statistical difference （P〉0.05）. The ratio of thickness of adenoids to anteroposterior diameter ofnasopharyngeal cavity was 0.79 ± 0.25 in group A, and 0.81 ± 0.31 in group B, with no statistical difference （P〉0.05）. The depth of lateral groove of adenoids of group A was （1.59 ± 0.54） mm, significantly lower than （2.84 ± 2.01） mm of group B, with statistical difference （P 〈0.05）. Conclusions Virtual endoscopic technique can accurately measure the thickness of adenoids and the size of effective ventilation space in nasopharynx, and evaluate the morphology of adenoid, which has important significance in diagnosis of OSAHS in children, and is worthy of clinical promotion and application.