鼻内窥镜下低温等离子消融术治疗小儿阻塞性睡眠呼吸暂停低通气综合征的效果探究

The effect of low temperature plasma ablation under nasal endoscope on obstructive sleep apnea hypopnea syndrome in children

目的:探究用鼻内窥镜下低温等离子消融术治疗小儿阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床效果。方法:选择2017年10月至2018年10月在沛县人民医院接受手术治疗的OSAHS患儿92例作为研究对象。采用随机数表法将这些患儿分为试验组和对照组(46例/组)。为对照组患儿采用腺样体刮除+扁桃体剥离术进行治疗,为试验组患儿采用鼻内窥镜下低温等离子消融术进行治疗,然后比较两组患儿的手术指标(包括手术的时间、术中的出血量和术后疼痛症状消失的时间)、手术应激反应指标(包括GSH和SOD)和肺通气指标(包括AHI、ODI、SLT90%、LAT和LSaO2)。结果:1)试验组患儿手术的时间、术后疼痛症状消失的时间均短于对照组患儿,其术中的出血量少于对照组患儿,P<0.05。2)在术后24 h,试验组患儿血清GSH、SOD的水平均高于对照组患儿,P<0.05。3)在术前,两组患儿的各项肺通气功能指标相比,P>0.05。在术后6个月,两组患儿的AHI、ODI、SLT90%均较术前明显降低,其LAT均较术前明显缩短,其LSaO2均较术前明显提高,P<0.05;与对照组患儿比较,试验组患儿的AHI、ODI、SLT90%均较低,其LAT较短,其LSaO2较高,P<0.05。结论:用鼻内窥镜下低温等离子消融术治疗小儿OSAHS的疗效显著,可有效地改善患儿的肺通气功能,且具有创伤小、患儿的手术应激反应小、术后疼痛时间短等优点。

Objective:To investigate the clinical effect of low temperature plasma ablation under nasal endoscope in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:92 children with OSAHS who received surgical treatment in Peixian People’s Hospital from October 2017 to October 2018 were selected as study subjects.The children were divided into experimental group and control group(46 cases/group)by random number table method.For children with the control group with adenoidectomy shave their+tonsil decollement treatment,children with nasal endoscope for test group plasma radiofrequency treatment at low temperature,and then compare the operation indexes of two groups of children(including in operation time,blood loss and postoperative pain symptoms disappear time),surgical stress response index(including GSH and SOD)and pulmonary ventilation index(including AHI,ODI,SLT90%,LAT and LSaO2).Results:1)The operation time and postoperative pain symptom disappearance time of the experimental group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).2)At 24 h after surgery,the serum LEVELS of GSH and SOD in the experimental group were higher than those in the control group(P<0.05).3)before the operation,compared with each pulmonary ventilation function index of the two groups,P>0.05.At 6 months after the operation,AHI,ODI and SLT90%of the children in the two groups were significantly reduced compared with that before the operation,LAT was significantly shortened compared with that before the operation,and LSaO2 was significantly increased compared with that before the operation(P<0.05).Compared with the control group,the AHI,ODI and SLT90%of the experimental group children were lower,their LAT was shorter,and their LSaO2 was higher,P<0.05.Conclusion:Low temperature plasma ablation under nasal endoscope has a significant effect on the treatment of OSAHS in children,which can effectively improve the pulmonary ventilation function of children,and has the advantages of less trauma,less surgical stress response and sh orter postoperative pain time.