低温等离子射频消融术治疗小儿腺样体肥大的临床疗效

Clinical efficacy of low temperature plasma radiofrequency ablation in the treatment of adenoid hypertrophy in children

目的探究低温等离子射频消融术治疗腺样体肥大对患儿通气功能、免疫指标及炎症因子的影响。方法选取2019年2月至2021年2月上饶市立医院收治的66例腺样体肥大患儿作为研究对象,按照随机数表法分为观察组与对照组,每组33例。对照组采用动力系统腺样体切吸术,观察组采用低温等离子消融术,比较两组围手术期指标、通气功能[双侧吸气总阻力(TIR)、双侧呼气总阻力(TER)、双侧鼻咽腔容积(NPV)]、免疫指标(IgA、IgG、IgM)、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素4(IL-4)]、并发症发生情况。结果观察组术中出血量少于对照组,鼻通气恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05);两组手术时间比较差异无统计学意义。术后1周,两组双侧TIR、TER均低于术前,双侧NPV均大于术前,且观察组双侧TIR、TER均低于对照组,双侧NPV大于对照组,差异有统计学意义(P<0.05)。术后1周,两组IgA、IgM、IgG水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术后1周,两组TNF-α、IL-4水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为6.06%,低于对照组的28.24%,差异有统计学意义(P<0.05)。结论低温等离子射频消融术治疗小儿腺样体肥大效果显著,术中损伤较小,在缓解通气功能受限和优化机体免疫功能及稳定炎症因子方面较动力系统腺样体切吸术更佳,值得临床推广应用。

Objective To explore the effect of low temperature plasma radiofrequency ablation on ventilation function,immune indicators and in-flammatory factors in children with adenoid hypertrophy.Methods 66 children with adenoid hypertrophy admitted to Shangrao Municipal Hospital from February 2019 to February 2021 were selected as the research subjects,and they were divided into the observation group and the control group according to the random number table method,with 33 cases in each group.The control group underwent dynamic system adenoidectomy,and the observation group underwent low temperature plasma ablation,the terms of perioperative indicators,ventilation function(bilateral total expiratory re-sistance[TER],bilateral nasopharyngeal volume[NPV],bilateral total inspiratory resistance[TIR]),immune indicators(IgA,IgG,IgM),inflammato-ry factors(TNF-α,interleukin 4[IL-4])and occurrence of complications were compared beween the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group,and the recovery time of nasal ventilation and hospital stay were shorter those in the control group,the differences were statistically significant(P<0.05);there was no significance difference in surgical time between the two groups.At 1 week after surgery,the bilateral TIR and TER of the two groups were lower than those before surgery,while the bilateral NPV was larg-er than that before surgery,and the bilateral TIR and TER in the observation group were lower than those in the control group,while the bilateral NPV was larger than that in the control group,the differences were statistically significant(P<0.05).At 1 week after surgery,the levels of IgA,IgM and IgG of the two groups were lower than those before surgery,and the observation group was lower than the control group,the differences were sta-tistically significant(P<0.05).At 1 week after surgery,the levels of TNF-αand IL-4 of the two groups were lower than those before surgery,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).The incidence rate of postoperative com-plications in the observation group was 6.06%,which was lower than 28.24%in the control group,the difference was statistically significant(P<0.05).Conclusion Low temperature plasma radiofrequency ablation has significant effect and small intraoperative injury in the treatment of adenoid hypertrophy,and it is better than dynamic system adenoidectomy in alleviating restricted ventilation function,optimizing body's immune function and stabilizing inflammatory factors.