低温等离子系统联合腺样体扁桃体切除术治疗OSAHS患儿的临床疗效及安全性分析

Clinical efficacy and safety of low temperature plasma system combined with adenotonsillectomy in the treatment of sick children with OSAHS

目的研究低温等离子系统联合腺样体扁桃体切除术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿的临床疗效及安全性。方法 OSAHS患儿518例,按手术方式分为传统手术组268例,等离子组250例。传统手术组采用传统腺样体扁桃体切除术,等离子组采用低温等离子系统联合腺样体扁桃体切除术,术后均随访6月。比较两组围术期相关指标,手术前及手术后6月呼吸紊乱指数、最低血氧饱和度及平均血氧饱和度及T淋巴细胞亚群,比较两组术后并发症发生率。结果等离子组住院时间、手术时间、术中出血量均低于传统手术组,差异有统计学意义(P <0. 05);与手术前相比,手术后两组患儿呼吸紊乱指数均降低,最低血氧饱和度及平均血氧饱和度水平均上升,CD8+降低,CD3+、CD4+、Ig A水平均上升,差异均有统计学意义(P <0. 05);等离子组术后出血发生率低于传统手术组,差异有统计学意义(P <0. 05)。结论低温等离子系统联合腺样体扁桃体切除术治疗OSAHS患儿疗效较好,术后出血比例更低。

Objective To investigate the clinical efficacy and safety of low temperature plasma system combined with adenotonsillectomy in the treatment of sick children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 518 sick children with OSAHS were divided into traditional surgery group(n=268)and plasma group(n=250)according to the surgery methods.The traditional surgery group was given traditional adenotonsillectomy,and the plasma group was given low temperature plasma system combined with adenotonsillectomy.AIl patients were followed up for 6 months after operation.The perioperative related indexes,respiratory disorder indexes,minimum oxygen saturation,average oxygen saturation and T lymphocyte subset before and after 6 months of operation were compared between the two groups.The incidence rate of postoperative complications was also compared between the two groups.Results The hospital stay,operative time and intraoperative blood loss in the plasma group were shorter or less than those in the traditional surgery group(P<0.05).Compared with before operation,respiratory disorder indexes after operation were decreased in the two groups while the minimum oxygen saturation and average oxygen saturation were increased(P<0.05).C D 8^+level was decreased while levels of CD3^+,IgA and CD4^+were increased(P<0.05).The incidence of postoperative bleeding in the plasma group was lower than that in the traditional surgery group(P<0.05).Conclusion Low temperature plasma system combined with adenotonsillectomy in the treatment of sick children with OSAHS has good efficacy and low proportion of postoperative bleeding.