摘要
目的探讨低温等离子消融术治疗儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的疗效及其安全性。方法2007年6月至2008年5月,对经多导睡眠监测证实为OSAHS的82例患儿(3～14岁,平均年龄6.2岁),在全麻下使用美国Arthrocare公司的ENT CoblatorⅡ等离子系统治疗仪,连接EVac70T&A刀头,切除扁桃体和(或)消融腺样体,并于术前及术后6个月行多导睡眠仪监测,以确定治疗效果。结果所有患儿术中、术后无明显并发症发生。术后随访6个月,患儿均取得满意疗效。与治疗前比较,在提高最低血氧饱和度和降低呼吸暂停低通气指数方面,差异有统计学意义(P<0.001)。随访6个月后,有45例患儿按疗效评定标准评定为治愈,21例显效,10例有效,6例无效,治疗总有效率达92.6%。结论低温等离子消融术具有较好的临床疗效,且手术时间缩短,术中术后出血少,术后疼痛明显减轻,并发症少,无不良反应,操作简单,可有效扩大鼻咽、口咽部通气截面积,解除上气道阻塞因素,尤其适合儿童OSAHS的手术治疗。
Objective To investigate the clinical efficacy and safety of coblation-assisted adenotonsillectomy for treatment of children with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods From June 2007 to May 2008, after monitoring polysomnography （PSG） confirmed 82 cases of OSAHS in children aged 3 to 14 years, with an average age of 6.2 years old, the ENT CoblatorII surgical instrument made by Arthrocare in the US and one-time EVac 70 T ＆ A apnea-hypopnea index （AHI） decreased significantly after the operation （P〈0.001）. In accordance with OSAHS diagnosis and efficacy evaluation standards, 45 patients were cured after 6 months, 21 patients showed an excellent effect, 10 patients showed a good effect, six patients had no effect, and the total effective rate was 92.6%. Conclusion Low-temperature coblation-assisted adenotonsillectomy has good clinical efficacy with a shortened surgical time, less intraoperative and postoperative blood loss, less postoperative pain, few complications, and a simple operation procedure. It can effectively expand the nasopharynx, oropharynx ventilation cross-sectional area, lift the upper airway obstruction, and can be especially suitable for surgical treatment of children with OSAHS.
出处
《中国循证医学杂志》
CSCD
2009年第6期709-712,共4页
Chinese Journal of Evidence-based Medicine
关键词
低温等离子消融术
儿童
阻塞性睡眠呼吸暂停低通气综合征
Low-temperature coblation-assisted adenotonsillectomy
Children
Obstructive sleep apnea-hypopnea syndrome
