低温等离子腺样体切除术对阻塞性睡眠呼吸暂停综合征患儿术后疼痛、睡眠、智力及心理行为的影响

Effects of low-temperature plasma adenoidectomy on postoperative pain,sleep,intelligence,and psychological behavior in children with obstructive sleep apnea hypopnea syndrome

目的探讨等离子腺样体切除术对阻塞性睡眠呼吸暂停综合征(OSAHS)患儿术后疼痛、睡眠、智力及心理行为的影响。方法将80例OSAHS患儿随机分为等离子组(39例)和对照组(41例)。对照组行常规鼻咽镜下腺样体切除术,等离子组行低温等离子腺样体切除术。比较两组患者的术后疼痛视觉模拟量表(VAS)评分、手术前后睡眠情况、智力及心理行为能力,并记录两组患儿术后并发症发生情况。结果术后第1、3、7天等离子组的VAS评分均低于对照组(均P<0.05)。术后1年,两组患儿的呼吸暂停指数、呼吸紊乱指数、中国-韦氏儿童智力量表(C-WISC)评分均较术前降低,最低血氧饱和度(LSaO2)、操作智商、言语智商、全量表智商较术前升高,且等离子组患儿呼吸暂停指数、呼吸紊乱指数、C-WISC评分低于对照组,LSaO2、操作智商、言语智商、全量表智商高于对照组(均P<0.05)。等离子组术后并发症发生率低于对照组(P<0.05)。结论与常规手术比较,等离子腺样体切除术可更有效地缓解OSAHS儿童术后疼痛,改善患儿睡眠、智力及心理行为能力。

Objective To investigate the effects of plasma adenoidectomy on postoperative pain,sleep,intelligence,and psychological behavior in children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Eighty children with OSAHS were randomly divided into plasma group(39 cases)and control group(41 cases).The control group underwent conventional nasopharyngoscopic adenoidectomy,whereas the plasma group underwent low-temperature plasma adenoidectomy.Postoperative Visual Analogue Scale(VAS)pain scores,pre-and postoperative sleep quality,intelligence,and psychological behavior ability were compared between the two groups.Besides,the incidence of postoperative complications was recorded in the two groups.Results On the 1st,3rd and 7th day after operation,the plasma group had lower VAS scores than the control group(all P<0.05).One year after operation,compared with the preoperative,apnea index,respiratory disturbance index,and the Chinese-Wechsler Intelligence Scale for Children(C-WISC)scores were decreased,whereas lowest arterial oxygen saturation(LSaO 2),performance intelligence quotient,verbal intelligence quotient,full intelligence quotient were increased,moreover,the plasma group exhibited lower apnea index,respiratory disturbance index and C-WISC scores,and higher LSaO 2,performance intelligence quotient,verbal intelligence quotient and full intelligence quotient as compared with the control group(all P<0.05).The plasma group had a lower incidence rate of postoperative complications than the control group(P<0.05).Conclusion Compared with conventional surgery,plasma adenoidectomy can ameliorate postoperative pain and improve sleep quality,intelligence and psychological behavior ability more effectively in OSAHS children.