2种术式用于儿童阻塞性睡眠呼吸暂停综合征的对照研究  

A Random- control Study of Two Different Surgeries in Treatment of Children with Obstructive Sleep Apnea- Hypopnea Syndrome

作　　者：谢亚柳[1] 崔榕[1] 包德刚[1] 罗智莘[1] 范敏[1] 

机构地区：[1]成都市第七人民医院,四川成都610041

出　　处：《现代临床医学》2013年第6期417-420,共4页Journal of Modern Clinical Medicine

摘　　要：目的:比较2种不同术式在治疗儿童阻塞性睡眠呼吸暂停综合征(OSAHS)时的疗效。方法:将154例OSAHS患儿随机分为2组,常规手术组在全麻下行传统扁桃体和腺样体切除术,改良手术组在全麻下行改良后的等离子低温消融法治疗。术后6个月至1年行多导睡眠监测,随访12~24个月。结果:2组患儿在术后临床症状及多导睡眠监测结果均较术前有明显改善,采用等离子低温消融法与采用传统术式相比,在提高最低血氧饱和度和降低呼吸暂停低通气指数方面有显著性差异(P<0.05)。结论:低温等离子消融术应用于儿童OSAHS较传统术式具有更好的临床疗效,同时还具有缩短手术时间、明显减轻术后疼痛、术中术后出血少、无不良反应、并发症少、操作简单等优点。通过改良手术治疗,可有效扩大口咽、鼻咽部通气截面积,解除或缓解上气道阻塞因素。Objective: To investigate the clinical efficacy and safety of two different surgery in treatments of children with obstructive sleep apnea hypopnea syndrome( OSAHS). Methods: 154 children with OSAHS were randomly divided in 2 groups. One received classic tonsillectomy and adenoidectomy while other received coblation- assisted surgery. Polysomnography monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect. Results: Data showed Both groups had all the amelioration in clinical symptoms and parameters of polysomnography. There were better oxygen saturation( LSaO 2) of increasing and apnea- hypopnea index( AHI) of decreaseing compared in the group of coblation- assited surgery with in group of classic tonsillectomy and adenoidectomy( P < 0. 05). Conclusion: Low- temperature coblation-assisted adenotonsillectomy have good clinical efficacy and 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 should be especially suitable surgical treatment in children with OSAHS.

关 键 词：儿童 阻塞性睡眠呼吸暂停综合征 低温等离子消融 

分 类 号：R766[医药卫生—耳鼻咽喉科]