低温盐水冲洗等离子腺样体切除治疗小儿鼾症的疗效和安全性观察

Study of low temperature saline water wash plasma adenoidectomy in treatment of children with snoring disease and delayed hemorrhage

目的观察低温盐水冲洗等离子腺样体切除术治疗小儿鼾症的临床疗效与安全性。方法选取2014年1月至2019年10月上海市奉贤区中心医院收治的小儿鼾症患儿609例,根据手术方式分为电动切割系统组(311例)和等离子组(298例)。采用魁北克睡眠评分(Quebec sleep questionnaire,QSQ)、Epworth嗜睡量表(Epworth sleeping scale,ESS)、疾病特异性生活质量调查量表(disease specific quality of life for children with obstructive sleep apnea 18 items survey,OSA-18)等,比较两组睡眠质量、生活质量、围术期相关指标、术后并发症与免疫功能方面的差异。结果术后,等离子组的QSQ高于电动切割系统组[(8.54±2.57)分比(6.36±2.81)分],ESS评分低于电动切割系统组[(7.48±2.91)分比(10.38±3.03)分,P<0.05];两组OSA-18量表评分均低于术前(P<0.05),且等离子组低于电动切割系统组[(32.67±7.82)比(35.42±5.89),P<0.05];等离子组住院时间[(6.92±0.53)d比(7.52±1.01)d]、手术时间[(34.73±4.65)min比(37.89±4.73)min]、术中出血量[(10.04±1.82)ml比(11.25±2.39)ml]及术后疼痛程度[(2.81±0.87)分比(4.45±1.96)分]均低于电动切割系统组(P<0.05)。两组术后发热、感染、出血及复发率比较,差异无统计学意义(P>0.05)。结论低温盐水冲洗等离子腺样体切除术治疗小儿鼾症整体效果优于电动切割系统。

Objectives To study clinical efficacy and safety of low temperature saline water wash plasma adenoidectomy in children with snoring disease.Methods A total of 298 children with snoring disease treated by low temperature saline water wash plasma adenoidectomy,and 311 children with snoring disease treated by traditional adenoidectomy were enrolled in the study.The sleep quality,living quality,perioperative period,postoperative complications and immune function were compared between the two groups using Quebec sleep questionnaire(QSQ),Epworth sleeping scale(ESS),disease specific quality of life for children with obstructive sleep apnea 18 items survey(OSA-18).Results After operation,the QSQ score was higher[(8.54±2.57)vs.(6.36±2.81)],the ESS score was lower[(7.48±2.91)vs.(10.38±3.03)]in the plasma adenoidectomyis group than those in the traditional adenoidectomy group(P<0.05).The QSA-18 score was lower[(32.67±7.82)vs.(35.42±5.89)]in the plasma adenoidectomyis group than those in the traditional adenoidectomy group(P<0.05),the QSA-18 score was lower after operation compared with before operation in both group(P<0.05).The hospital stay[(6.92±0.53)d vs.(7.52±1.01)d],operation time[(34.73±4.65)min vs.(37.89±4.73)min],hemorrhage during operation[(10.04±1.82)ml vs.(11.25±2.39)ml]and light post-operation pain[(2.81±0.87)vs.(4.45±1.96)]in the plasma adenoidectomyis group were higher than those in the traditional adenoidectomy group(P<0.05).There was no significant difference on the rate of postoperative fever,infection,bleeding and recurrence between the two groups(P>0.05).Conclusions Low temperature saline water wash plasma adenoidectomy has better clinical efficacy and higher safety than traditional adenoidectomy in the treatment of children with snoring disease.