动力系统腺样体切吸术联合扁桃体部分切除术和扁桃体全切术治疗儿童OSAHS的临床疗效

Clinical efficacy of dynamic system adenoidectomy combined with partial tonsillectomy and total tonsillectomy in the treatment of children with OSAHS

目的探讨采用动力系统腺样体切吸术联合扁桃体全切术和扁桃体部分切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效。方法回顾性分析2017年5月至2019年11月本院及中山市人民医院收治的52例OSAHS患儿的临床资料,根据手术方式不同分为A组(n=25)与B组(n=27)。A组采用动力系统腺样体切吸术联合扁桃体部分切除术,B组采用动力系统腺样体切吸术联合扁桃体全切术。比较两组术中出血量、白膜脱落时间、术后24 h视觉模拟评分法(VAS)评分、手术时间、最低动脉氧饱和度(LSaO2)、睡眠呼吸低通气指数(AHI)及术后并发症发生情况。结果A组术后24 h VAS评分低于B组,术中出血量少于B组,手术时间短于B组,差异有统计学意义(P<0.05)。术后6个月,两组LSaO2水平均高于术前,AHI水平均低于术前,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义。结论采用动力系统腺样体切吸术联合扁桃体部分切除术和扁桃体全切术治疗OSAHS患儿均具有一定的疗效及安全性,且动力系统腺样体切吸术联合扁桃体部分切除术的创伤较小,术后疼痛程度较轻,值得临床推广应用。

Objective To investigate the clinical efficacy of dynamic system adenoidectomy combined with total tonsillectomy and partial tonsillectomy in the treatment of children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods The clinical data of 52 children with OSAHS admitted to our hospital and Zhongshan People's Hospital from May 2017 to November 2019 were retrospectively analyzed,they were divided into group A(n=25)and group B(n=27)according to different surgical methods.The intraoperative blood loss,albuginea shedding time,24 h postoperative visual analogue scale(VAS)score,operation time,lowest arterial oxygen saturation(LSaO2),apnea hypopnea index(AHI)and postoperative complications were compared between the two groups.Results 24 h post operative the VAS score of group A was lower than that of group B,the intraoperative blood loss was less than that of group B,and the operation time was shorter than that of group B,and the differences were statistically significant(P<0.05).6 months after operation,the levels of LSaO2 in the two groups were higher than those before operation,and the levels of AHI were lower than those before operation,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups.Conclusion Dynamic system adenoidectomy combined with partial tonsillectomy and total tonsillectomy have certain efficacy and safety in the treatment of children with OSAHS,and dynamic system adenoidectomy combined with partial tonsillectomy is less traumatic,the degree of postoperative pain is mild,and it is worthy of clinical application.