摘要
目的 探讨鼻内镜下经口切割和低温等离子消融术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿咽鼓管功能、生活质量的影响及其安全性。方法 选取该院2015年1月至2017年12月收治的OSAHS患儿共136例,以随机数字表法分为A组和B组(各68例),A组给予鼻内镜下经口切割治疗,B组给予低温等离子消融术治疗;比较两组患儿近期疗效、手术相关临床指标,手术前后咽鼓管功能指标、最低血氧饱和度(LSaO2)、呼吸暂停低通气指数(AHI)、儿童OSAHS疾病特异性生活质量调查(OSA-18)评分、非快速眼动期(NREM)、快速眼动期(REM),以及术后并发症发生率。结果 两组患儿总有效率比较,差异无统计学意义(P>0.05);B组患儿腺样体切除时间、总手术时间及术中出血量均明显少于A组(P<0.05);B组患儿治疗后最大鼓室压差值明显高于A组及治疗前(P<0.05);两组治疗后LSaO2、AHI、NREM及REM无明显差异(P>0.05),但均明显优于治疗前(P<0.05);两组患儿治疗前后咽鼓管功能障碍率和OSA-18评分均无明显差异(P>0.05);B组患儿术后继发出血发生率明显高于A组(P<0.05),两组患儿术后圆枕损伤和腺样体残留发生率无明显差异(P>0.05)。结论 鼻内镜下经口切割和低温等离子消融术用于OSAHS患儿总体疗效接近,低温等离子消融术能够有效缩短手术用时,减少术中出血量,并有助于改善咽鼓管功能,但继发出血风险较鼻内镜下经口切割高。
Objective To investigate the influence of endoscopic adenoid hypothermic cleavage and endoscopic adenoid hypothermic plasma ablation on eustachian tube function,quality of life and safety in children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 136 children with OSAHS in this hospital from January 2015 to December 2017 were enrolled and randomly divided into group A and group B,68 cases in each group.Group A was given endoscopic adenoid hypothermic cleavage,and group B was given endoscopic adenoid hypothermic plasma ablation.The short-term clinical efficacy,surgical-related clinical indicators,eustachian tube function index,minimum oxygen saturation(LSaO 2),apnea hypopnea index(AHI),and children′s OSAHS disease-specific quality of life(OSA-18)score,non-rapid eye movement(NREM)and rapid eye movement(REM)before and after treatment,and postoperative complications were compared between the two groups.Results There was no significant difference in the total clinical effective rate between the two groups(P>0.05).The adenoidectomy time,total operation time and intraoperative bleeding loss volume in group B were significantly lower than those in group A(P<0.05).The difference of maximum tympanum pressure after treatment in group B was significantly higher than that in group A and before treatment(P<0.05).The LSaO 2,AHI,NREM and REM after treatment were significantly better than those before treatment in the two groups(P<0.05),while no significant difference was found in LSaO 2,AHI,NREM and REM after treatment between the two groups(P>0.05).There was no significant difference in the eustachian tube dysfunction rate and OSA-18 score before and after treatment between the two groups(P>0.05).The secondary hemorrhage rate after operation in group B was significantly higher than that in group A(P<0.05).No significant difference was found in the postoperatively rounded occipital injury rate and adenoid remnant rate between the two groups(P>0.05).Conclusion The total clinical efficacy of endoscopic
作者
唐正琪
TANG Zhengqi(Department of Otolaryngology Head and Neck,Zigong Third People′s Hospital,Zigong,Sichuan 643020,China)
出处
《重庆医学》
CAS
2019年第23期4035-4038,共4页
Chongqing medicine
