低温等离子扁桃体切除术在OSAHS患儿中的应用及对血清免疫球蛋白与T淋巴细胞亚群的影响

Application of Low Temperature Plasma Tonsillectomy in Children with OSAHS and its Influence on Serum Immunoglobulins and T Lymphocyte Subsets

目的:研究低温等离子扁桃体切除术在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿中的应用及对血清免疫球蛋白与T淋巴细胞亚群的影响。方法:选取2016年9月至2017年8月因扁桃体肥大而致的88例OSAHS患儿,根据随机数字法分为观察组和对照组,44例每组。对照组采取传统扁桃体切除术,观察组采取低温等离子扁桃体切除术。分析两组患儿术中术后情况及术后疼痛感,比较两组患儿治疗前和治疗1个月后血清免疫球蛋白与T淋巴细胞亚群水平。结果:观察组的术中出血量、手术时间、住院时间显著少于对照组(P<0.05),但观察组的术后白膜脱落时间显著长于对照组(P<0.05)。术后1d、3d、5d、7d,观察组患儿的疼痛评分显著低于对照组(P<0.05)。治疗前,两组患儿IgA、IgG、IgM免疫球蛋白水平比较无显著差异(P>0.05),治疗1个月后,对照组患儿IgA、IgG、IgM免疫球蛋白水平较治疗前显著降低(P<0.05),观察组患儿的IgA、IgG、IgM免疫球蛋白水平和治疗前相比无明显差异(P<0.05),观察组的IgA、IgG、IgM免疫球蛋白水平显著高于对照组(P<0.05)。治疗前,两组患者CD3+、CD4+、CD8+细胞百分率及CD4+/CD8+比值比较无显著差异(P>0.05),治疗1个月后,对照组患者的CD3+、CD4+、及CD4+/CD8+比值较治疗前显著降低(P<0.05),CD8+百分率较治疗前显著升高,但观察组患者在治疗1个月后的CD3+、CD4+、CD8+细胞百分率及CD4+/CD8+比值和治疗前相比无明显差异(P>0.05),观察组患者的CD3+、CD4+、及CD4+/CD8+比值显著高于对照组(P<0.05),CD8+细胞百分率显著低于对照组(P<0.05)。结论:低温等离子扁桃体切除术在OSAHS患儿中应用,并不会对患儿血清免疫球蛋白与T淋巴细胞亚群造成影响,较少的术中出血量、手术时间及住院时间,术后疼痛程度较轻。

Objective:To study the application of low temperature plasma tonsillectomy in children with obstructive sleep apnea hypopnea syndrome(OSAHS)and the effect on serum immunoglobulin and T lymphocyte subsets.Methods:88 cases of children with OSAHS from September 2016 to August 2017 were selected in our hospital.All the children were divided into observation group and control group according to random number method.The control group was treated with the traditional tonsillectomy,and the observation group was given low-temperature plasma tonsillectomy.Two groups of patients with intraoperative and postoperative situation,as well as postoperative pain were analyzed,the levels of serum immunoglobulins and T lymphocyte subsets were compared between the two groups before and after 1 month of treatment.Results:The blood loss,operation time and length of hospital stay in the observation group were significantly shorter than the control group(P<0.05),but the time of alopecia in the observation group was longer than the control group(P<0.05).On the 1st,3rd,5th and 7th day postoperatively,the pain scores of the observation group were significantly lower than the control group(P<0.05).The levels of IgA,IgG and IgM immunoglobulins in the two groups were not significantly different(P>0.05).After one month of treatment,IgA,IgG and IgM immunoglobulin levels in the control group were significantly higher than before treatment,IgM,IgG and IgM immunoglobulins in the observation group were not significantly different compared with before treatment(P<0.05).The levels of IgA,IgG and IgM immunoglobulins in the observation group were significantly higher than the control group(P<0.05).There was no significant difference in the percentage of CD3+,CD4+,CD8+and CD4+/CD8+between the two groups before treatment(P>0.05).After one month of treatment,the ratio of CD3+,CD4+,CD4+/CD8+CD8+and CD4+/CD8+ratio in the treatment group were significantly lower than those before treatment(P<0.05),but there was no significant difference in CD3+,CD4+,CD8+(P<0.05).The percentage of CD8+,CD8+and CD4+/CD8+in observation group were significantly higher than control group(P<0.05).Conclusion:Low temperature plasma tonsillectomy in children with OSAHS does not affect serum immunoglobulin and T lymphocyte subsets,less intraoperative bleeding,operation time and hospital stay,postoperative pain is less.