摘要
目的探讨小儿鼾症采用鼻内窥镜下低温等离子射频消融腺样体联合双侧扁桃体切除术对其应激反应及通气功能的影响。方法选择本院2018年8月至2018年12月收治的60例鼾症患儿,按抽签法分为对照组和观察组,各30例。对照组采用腺样体切除与扁桃体剥离术治疗,观察组采用鼻内窥镜下低温等离子射频消融腺样体联合双侧扁桃体切除术治疗。术后随访6个月,比较两组围术期指标、应激反应、通气功能指标。结果观察组术中出血量(16.54±3.57)ml、术后皮质醇(158.41±9.65)ng/ml、中性粒细胞(4.33±1.05)×10^3/ml低于对照组,手术时间(26.33±4.06)min、症状缓解时间(7.02±2.09)d、术后疼痛时间(2.71±1.30)d短于对照组,ACTH(15.32±3.14)ng/L水平高于对照组,差异有统计学意义(P<0.05);术后6个月,观察组AHI(9.35±3.47)h、ODI(8.27±3.15)h、LAT(17.33±3.29)s均低于对照组,LSaO2(86.12±8.24)s高于对照组,差异有统计学意义(P<0.05)。结论小儿鼾症采用鼻内窥镜下低温等离子射频消融腺样体联合双侧扁桃体切除术治疗可减轻机体创伤性,改善通气功能,缓解术后应激反应,促进患儿康复。
Objective To investigate the effect of nasal endoscopic low temperature plasma radiofrequency ablation combined with bilateral tonsillectomy on stress response and ventilation function in children with snoring disease. Methods 60 children with snoring disease admitted in the hospital from August 2018 to December 2018 were selected, and they were divided into control group and observation group by draw lots, with 30 cases in each group. Control group was given adenoidectomy and tonsillectomy, while observation group was treated with nasal endoscopic low temperature plasma radiofrequency ablation and bilateral tonsillectomy. After postoperative 6-month follow-up, the perioperative indexes, stress response and ventilation function indexes were compared between the two groups. Results The intraoperative bleeding volume, postoperative cortisol and neutrophil in observation group [(16.54±3.57) ml,(158.41±9.65) ng/ml,(4.33±1.05)×10^3 /ml] were lower than those in control group, the op- eration time, relief time of symptoms and postoperative pain time in observation group [(26.33±4.06) min,(7.02±2.09) d,(2.71±1.30) d] were short- er than those in control group, the ACTH in observation group [(15.32±3.14) ng/L] was higher than that in control group (P<0.05);After surgery for 6 months, the AHI, ODI and LAT in observation group [(9.35±3.47) h,(8.27±3.15) h,(17.33±3.29) s] were lower than those in control group, while the LSaO 2 in observation group [(86.12±8.24) s] was higher than that in control group, the different has statistical significance (P<0.05). Conclusion Nasal endoscopic low temperature plasma radiofrequency ablation combined with bilateral tonsillectomy in treatment of children with snoring disease can reduce trauma, improve ventilation function, relieve postoperative stress response, and promote rehabilitation of children.
作者
林飞
彭喜兵
Lin Fei;Peng Xibing(Department of Otolaryngology, Shangrao Municipal Hospital, Shangrao, Jiangxi, 334000, China;Department of Otolaryngology, Wannian County People' s Hospital, Shangrao, Jiangxi, 334000, China)
出处
《当代医学》
2019年第29期12-14,共3页
Contemporary Medicine
关键词
小儿鼾症
鼻内窥镜
低温等离子射频消融腺样体
双侧扁桃体切除术
通气功能
应激反应
Children with snoring disease
Nasal endoscope
Low temperature plasma radiofrequency ablation
Bilateral tonsillectomy
Ventila-tion function
Stress response