鼻内镜联合低温等离子射频消融腺样体切除术在鼾症患儿中的应用

Nasal endoscopy combined with cryogenic plasma radiofrequency ablation of adenoidectomy in children with snoring

目的:探讨鼻内镜联合低温等离子射频消融腺样体切除术对鼾症(SD)患儿术后12个月通气功能、睡眠质量、认知功能、生活质量及疗效产生的影响。方法:采用随机抽签法将112例SD患儿均分为两组,对照组接受鼻动力切割腺样体切除术治疗,观察组实施鼻内镜引导下的低温等离子射频消融腺样体切除术治疗。比较两组患儿术前、术后2月及12月三个时间段通气功能[LSa(O2)、AHI及ODI]、睡眠状况[用PSQ及ESS评估]、生活质量、认知功能及末次复查时治疗总有效率。结果:术前两组各通气功能指标、睡眠质量评分、生活质量评分及认知功能评价指标间比较,差异无统计学意义(P>0.05)。术后,随时间延长,两组LSa(O2)均呈明显上升趋势,AHI、ODI、PSQ及ESS评分呈明显下降趋势,且观察组患儿上述通气功能指标及睡眠质量评分均明显优于对照组(P<0.05)。结论:鼻内镜引导下低温等离子射频消融腺样体切除术可通过加强通气功能及睡眠质量,长期有效改善患儿生活质量及认知功能,提高治疗效率。

Objebtive:To investigate the effect of nasal endoscopy combined with low-temperature radiofrequency ablation on the ventilatory function,sleep quality,cognitive function,quality of life and therapeutic effect on children with snoring(SD)at 12 months after treatment.Methord:112 children with SD were divided into two groups by random sampling.The cases of the control group were treated with nasal adenoidectomy,and the cases of the observation group were treated with endoscopic nasopharyngeal cryogenic plasma radiofrequency ablation of adenoidectomy.Ventilatory function[(LSa(O2),AHI,and ODI,sleep status[assessed by PSQ and ESS,quality of life(OSA-18 volume of life),cognitive function(assessed by CPT,n-back and CWT)and total response rate at the last review were compared between the two groups at preoperative,postoperative 2 months and postoperative 12 months.Results:There was no significant difference between the two groups in the ventilation function,sleep quality score,quality of life score and cognitive function evaluation index(P>0.05).After operation,the LSa(O2)in both groups showed a significant increase as time prolongs,and the scores of AHI,ODI,PSQ and ESS decreased significantly,and the indexes of the observation group were significantly better than those in the control group(P<0.05).12 months after surgery,the indexes of cognitive function in both groups were significantly improved,and the indexes in the observation group were significantly better than those in the control group(P<0.05).The total effective rate of the observation group 12 months after surgery was as high as 98.08%,and that was significantly higher than that of the control group(87.04%)(P<0.05).Conclusion:Endoscopic low temperature plasma radiofrequency ablation can improve ventilation quality and sleep quality,long-term effective in improving children's quality of life and cognitive function,improve the treatment efficiency.