内镜切除腺样体治疗扁桃体腺样体肥大所致阻塞性睡眠呼吸暂停综合征患儿的效果

Effects of endoscopic adenoidectomy in treatment of children with obstructive sleep apnea syndrome caused by tonsil adenoid hypertrophy

目的:观察内镜切除腺样体治疗扁桃体腺样体肥大所致阻塞性睡眠呼吸暂停综合征(OSAHS)患儿的效果。方法:选取94例扁桃体腺样体肥大所致OSAHS患儿作为研究对象,依据随机数字表法分为观察组与对照组各47例。对照组采用常规手术治疗,观察组采用内镜切除腺样体治疗,比较两组临床疗效、手术相关指标水平、治疗前后夜间多导睡眠图(PSG)监测指标[睡眠呼吸暂停指数(AI)、平均呼吸暂停时间(MAT)、低通气指数(HI)、呼吸紊乱指数(AHI)、最低动脉血氧饱和度(SaO2)]水平及X线头影测量指标[下齿槽座角(SNB)、下颌平面角(SN-MP)、上后气道间隙(SPAS)、中气道间隙(MAS)、软腭长度(SPL)]水平。结果:观察组治疗有效率为95.74%,明显高于对照组的82.98%,差异有统计学意义(P<0.05);观察组手术时间短于对照组,术中出血量、血清瘦素含量均明显低于对照组,差异均有统计学意义(P<0.05);治疗后观察组AI、MAT、HI、AHI、最低动脉SaO2、SNB、SN-MP、SPAS、MAS及SPL水平优于对照组,差异均有统计学意义(P<0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:内镜切除腺样体治疗扁桃体腺样体肥大所致OSAHS患者可提高治疗有效率,缩短手术时间术中出血量、血清瘦素含量和术后并发症发生率,改善临床相关指标水平,效果优于常规手术治疗效果。

Objective:To observe endoscopic adenoidectomy in treatment of children with obstructive sleep apnea syndrome caused by tonsil adenoid hypertrophy(OSAHS).Methods:94 children with OSAHS caused by tonsil adenoid hypertrophy were selected as the research objects,and were divided into observation group and control group according to the random number table method,47 cases in each group.The control group was treated with conventional surgery,while the observation group was treated with endoscopic adenoidectomy.Then,the clinical efficacy,surgery-related index levels,night polysomnography(PSG)monitoring index[sleep apnea index(AI),mean apnea time(MAT),hypopnea index(HI),apnea hyponea index(AHI),and minimum arterial oxygen saturation(SaO2)]levels,and X-ray cephalometric indicator[sella-nasion-B point(SNB),mandibular plane angle(SN-MP),upper posterior airway space(SPAS),middle airway space(MAS),soft palate length(SPL)]levels were compared between the two groups.Results:The effective rate in the observation group was 95.74%,which was significantly higher than 82.98%in the control group,and the difference was statistically significant(P<0.05).The operation time,intraoperative blood loss,and serum leptin content of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of AI,MAT,HI,AHI,lowest arterial SaO2,SNB,SN-MP,SPAS,MAS and SPL level was better than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Endoscopic adenoidectomy in the treatment of the children with OSAHS caused by tonsil adenoid hypertrophy can improve the treatment effective rate,reduce the operation time,intraoperative blood loss,serum leptin content and the incidence of postoperative complications,and improve the clinical related indicator levels.Moreover,it is superior to conventional surgical treatment.