扁桃体全切除与部分切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征的效果比较

Effect comparison of total tonsillectomy and partial tonsillectomy in the treatment of obstructive sleep apnea hypopnea syndrome in children

目的比较扁桃体全切除(TE)与部分切除手术(TT)治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的效果。方法回顾性分析2021年1月至6月江西省儿童医院收治的200例OSAHS患儿的临床资料,按照不同的手术方式分为对照组(n=140)和观察组(n=60)。两组患儿的手术均在低温等离子辅助下进行,对照组患儿采用TE术,观察组患儿采取TT术,比较两组的手术效果、睡眠质量、呼吸暂停指数(AH)、低通气指数(HI)及与呼吸事件相关微觉醒指数(MAI)、血气指标、并发症发生率。结果两组的总有效率比较,差异无统计学意义(P>0.05)。术后,观察组特异性生活质量调查表(OSA-18)评分低于对照组,差异有统计学意义(P<0.05)。观察组AHI、HI及MAI指数低于对照组,差异有统计学意义(P<0.05)。术后,观察组pH值、动脉血氧分压(PaO2)高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论对于儿童OSAHS患儿采用TT术效果较好,术中出血量少、术后疼痛更轻,并发症少。

Objective To compare the effects of total tonsillectomy(TE)and partial tonsillectomy(TT)in the treatment of obstructive sleep apnea hypopnea syndrome in children(OSAHS).Methods A total of 200 children with OSAHS treated in Jiangxi Children′s Hospital from January 2021 to June 2021 were analyzed retrospectively.They were divided into control group(140 cases)and observation group(60 cases).The children in the two groups were assisted by low-temperature plasma.The children in the control group were treated with TE and the children in the observation group were treated with TT.The surgical effect,sleep quality,apnea index(AH),hypopnea index(HI),respiratory event related microawakefulness index(MAI),blood gas index and incidence of complications of the two groups were compared.Results There was no significant difference in the total effective rate between the two groups(P>0.05).After operation,the score of specific quality of life questionnaire(OSA-18)in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).AHI,HI and MAI indexes in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After operation,the pH value and arterial partial pressure of oxygen(PaO2)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than in the control group,the difference was statistically significant(P<0.05).Conclusion TT is effective for children with OSAHS,with less bleeding,less pain and fewer complications.