下鼻甲黏膜下等离子消融术对变应性鼻炎合并阻塞性睡眠呼吸暂停综合征患儿疗效及安全性初步研究

Preliminary study on efficacy and safety of submucosal plasma ablation of inferior turbinate in children with allergic rhinitis complicated with obstructive sleep apnea syndrome

目的:探讨下鼻甲黏膜下等离子消融联合或不联合扁桃体腺样体手术,对经系统保守治疗症状无效的变应性鼻炎(AR)合并阻塞性睡眠呼吸暂停综合征(OSAS)患儿的临床中远期疗效及其安全性。方法:回顾性分析2019年1月-2022年2月住院治疗的AR合并OSAS 68例患儿中符合入选标准且随访1年以上的43例患儿的临床资料,对患儿临床特征、手术方法、围手术期处理、并发症的防治、手术前后患儿的VAS评分、中远期疗效和并发症等数据进行分析归纳。结果:患儿手术平均耗时36 min,术中出血少,术后鼻塞、流涕、睡眠打鼾、张口呼吸等VAS评分较术前低,随访1年疗效满意,无术后出血、血肿、术腔粘连、鼻腔干燥等并发症。结论:下鼻甲黏膜下等离子消融术联合或不联合扁桃体腺样体手术可有效改善经保守治疗无效的AR伴OSAS患儿的临床症状,既改善术后鼻塞、鼻涕等AR症状,也改善睡眠打鼾、张口呼吸等睡眠呼吸障碍症状,中远期疗效好,并发症少,是治疗儿童AR合并OSAS有效和安全的方法。

Objective:This study aimed to investigate the long-term clinical efficacy and safety of inferior turbinate submucosal plasma ablation combined with or without tonsillar and adenoid surgery in children with allergic rhinitis(AR)combined with obstructive sleep apnea syndrome(OSAS)who were ineffective after conservative systemic treatment.Methods:A total of 43 children with AR complicated with OSAS who met the inclusion criteria among 68 children hospitalized from January 2019 to February 2022 were retrospectively analyzed.The data were collected,including the clinical characteristics,surgical methods perioperative management and prevention and treatment of complications.Moreover,one year follow-up was performed to compare the VAS scores of children before and after surgery,and to evaluate their mid-term and long-term outcomes.Results:The average operation time was 36 minutes,meanwhile,the intraoperative blood was limited.The symptoms of nasal congestion,runny nose,sleep snoring,and mouth breathing were significantly improved after operation,and the results were satisfactory after one-year follow-up without complications such as bleeding,hematoma,intraoperative adhesion,and nasal dryness.Conclusion:Submucosal plasma ablation of inferior turbinate with or without tonsillectomy adenoidectomy in children with AR can effectively improve the clinical symptoms of AR combined with OSAS children who are ineffective after conservative treatment.It can improve the symptoms of sleep-disordered breathing such as sleep snoring and mouth breathing,with good mid-and long-term curative effects and fewer complications,which is an effective and safe treatment for children with AR combined with OSAS.