扁桃体部分切除术治疗儿童阻梗性睡眠呼吸暂停综合征86例

Partial tonsillectomy for 86 cases of obstructive sleep apnea syndrome in children

目的探讨扁桃体部分切除术治疗儿童阻塞性睡眠呼吸暂停综合征(OSA)的疗效。方法回顾性分析172例接受手术治疗的OSA患儿病历资料,将患儿分为对照组(n=86)和观察组(n=86),对照组患儿使用扁桃体全部切除术,观察组患儿使用扁桃体部分切除术,对比治疗的效果。结果两组的术后原发性出血比例差异不具有统计学意义(χ^(2)=0.000,P>0.999),对照组术后继发性出血的比例高于观察组(χ^(2)=4.317,P=0.038),观察组的伪膜脱落时间早于对照组(t=7.393,P<0.001),对照组在术后1 d, 3 d的疼痛评分均高于观察组(t=5.376,8.881,P<0.001),两组的复发率和感染率差异均无统计学意义(χ^(2)=0.506,0.256,P=0.613)。结论扁桃体部分切除术治疗儿童OSA患者,可改善术后继发性出血,降低术后的疼痛程度,促进术后恢复,可以作为常规扁桃体切除术的有效替代方案。

Objective To investigate the complications of partial tonsillectomy in children with obstructive sleep apnea(OSA). Methods In this study, a total of 172 children with OSA who underwent surgery at our hospital from June 2018 to December 2018 were enrolled. The children were divided into a control group(n=86) and an observation group(n=86). The control group underwent tonsillectomy and the observation group underwent partial tonsillectomy. The effects of treatment were compared between the groups. Result There was no statistically significant difference in the occurrence of postoperative primary bleeding between the two groups(χ^(2)=0.000, P>0.999). The proportion of secondary bleeding was higher in the control group than that in the observation group(χ^(2)=4.317, P<0.038). The pseudomembrane shedding time in the observation group was earlier than that in the control group(t=7.393, P<0.001). The pain scores of the control group at 1 d and 3 d after operation were higher than those of the observation group(t=5.376, 8.881, P<0.001). There were no significant differences in the recurrence rate and infection rate between the two groups(χ^(2)=0.506, 0.256, P=0.613). Conclusion Partial tonsillectomy may reduce postoperative secondary hemorrhage and postoperative pain, and promote postoperative recovery in children with OSA. It can be considered a valid alternative to conventional tonsillectomy in pediatric OSA syndrome.