低温等离子腺样体联合双侧扁桃体切除对小儿鼾症患者最低动脉血氧饱和度和睡眠质量的影响

Effect of Low-temperature Plasma Adenotectomy Combined with Bilateral Tonsillectomy on Minimum Arterial Oxygen Saturation and Sleep Quality in Children with Snoring

目的探讨低温等离子腺样体切除联合双侧扁桃体切除对小儿鼾症(SD)患者最低动脉血氧饱和度[LSa(O_2)]和睡眠质量的影响。方法选取2014年5月-2016年5月我院收治的72例小儿SD患者作为研究对象,按其临床治疗特征将其分为对照组和观察组,每组36例,在SD常规治疗基础上观察组患者予以低温等离子射频消融术腺样体切除联合双侧扁桃体切除术治疗,对照组予以动力切割系统切除腺样体联合常规剥离双侧扁桃体手术治疗,根据临床及随访资料比较2组患者手术情况、临床疗效及手术前后其呼吸暂停低通气指数(AHI)、LSa(O_2)和睡眠质量的变化。结果观察组手术情况明显优于对照组,比较差异有统计学意义(P<0.05);2组患者术后临床总有效率比较差异无统计学意义(P>0.05);2组患者手术前后其AHI、LSa(O_2)、QSQ评分及ESS评分均较前改善,且观察组改善程度与对照组比较差异有统计学意义(P<0.05)。结论低温等离子射频消融术腺样体切除联合双侧扁桃体切除术治疗SD临床疗效较好,可明显改善患儿LSa(O2)及睡眠质量。

Objective To investigate the effects of low-temperature plasma adenoidectomy combined with bilateral tonsil- lectomy on the lowest arterial oxygen saturation [ LSa （ 02 ） ] and sleep quality in children with snoring. Methods A total of seven- ty-two pediatric patients with snoring admitted to our hospital between May 2014 and May 2016 were selected as subjects and e- qually divided into the control group and observation group according to their clinical characteristics. Both groups received routine treatment for snoring. The patients in the control group were treated with low temperature plasma radiofrequency ablation combined with adenoidectomy and bilateral tonsillectomy while those in the observation group were treated with dynamic incision of adenoid- ectomy combined with conventional detachment of bilateral tonsils. AHI, LSa （ O2 ） and sleep quality were compared between the two groups according to the clinical and follow-up data. Results The surgical effect in the observation group was significantly bet- ter than that of the control group with statistically significant difference （P〈0.05）, but no significant difference was observed in the total effective rate between the two groups （P〉0. 05 ）. AHI, LSa （ O2 ）, QSQ and ESS scores of the two groups were improved after operation,especially in the observation group （P〈0.05）. Conclusion Low-temperature plasma radiofrequency ablation of adenoidectomy combined with bilateral tonsillectomy is effective, and can improve the quality of LSa （O2 ） and sleep.