鼻内窥镜下低温等离子射频消融术与扁桃体联合腺样体切除术治疗小儿鼾症伴过敏性鼻炎疗效比较  

Comparison on curative effect of endoscopic low temperature plasma radiofrequency ablation and tonsillectomy combined with adenoidectomy in the treatment of snoring disease in children with allergic rhinitis

作　　者：任小东[1] 蒋晓平[1] 陈天宾[1] 陈林峰[2] 

机构地区：[1]重庆三峡中心医院,重庆404000 [2]重庆三峡中心医院百安分院,重庆404100

出　　处：《现代中西医结合杂志》2017年第9期928-931,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的比较鼻内窥镜下低温等离子射频消融术与扁桃体联合腺样体切除术治疗小儿鼾症伴过敏性鼻炎的临床疗效。方法将110例鼾症伴过敏性鼻炎患儿随机分为观察组55例和对照组55例,观察组行鼻内窥镜下低温等离子射频消融术,对照组行扁桃体摘除联合鼻内镜下腺样体切除术。比较2组手术时间、术中出血量、术后疼痛时间、症状缓解时间,采用酶联免疫吸附实验(ELISA)检测2组术后24 h丙二醛(MDA)、硝基酪氨酸(3-NT)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)水平;术后6个月,评价2组临床疗效;采用多导睡眠图检测2组术前、术后6个月的呼吸紊乱指数(AHI)、氧减指数(ODI)、最长呼吸暂停时间(LAT)、最低夜间血氧饱和度[LSa(O_2)]。结果观察组总有效率显著高于对照组(P<0.05);观察组手术时间、术后疼痛时间、症状缓解时间均显著短于对照组(P均<0.05),术中出血量显著少于对照组(P<0.05);观察组MDA、3-NT水平显著低于对照组(P均<0.05),SOD、GSH水平显著高于对照组(P<0.05);2组术后AHI、ODI、LAT水平均显著降低(P均<0.05),LSa(O_2)水平均显著升高(P均<0.05),且观察组各指标改善情况明显优于对照组(P均<0.05)。结论鼻内窥镜低温等离子射频消融术更有利于减轻鼾症伴过敏性鼻炎患儿术后应激反应,改善通气功能,且创伤小、疼痛轻、恢复快,安全有效。Objective It is to compare the clinical curative effect of endoscopic low temperature plasma radiofrequency ab- lation and tonsillectomy combined with adenoidectomy in the treatment of snoring disease in children with allergic rhinitis. Methods 110 cases of snoring patients with allergic rhinitis were randomly divided into observation group and control group, 55 cases in each group. The patients were treated with endoscopic low temperature plasma radiofrequeney ablation in the observa- tion group, and with tonsillectomy combined with adenoidectomy in the control group. The operation time, intraoperative bleeding volume, postoperative pain time, symptoms remission time of the two groups were compared, the levels of malondial- dehyde （MDA） , nitrotyrosine （ 3 - NT） , superoxide dismutase （SOD） and glutathione （ GSH ） were detected by enzyme- linked immunosorbent assay （ELISA） in two groups after 24-hour of operation; 6 months after operation, the clinical curative effects of the two groups were evaluate; the respiratory disturbance index （AHI） and oxygen desaturation index （ODI） , the longest apnea time （LAT） , the lowest nocturnal oxygen saturation （ LSa（ 02 ） ） in the two groups were detected by polysom- nography before and after 6 months. Results The total effective rate of the observation group was significantly higher than that of the control group （P 〈 0.05 ） ; the operation time, postoperative pain time, symptoms remission time of the observation group were significantly shorter and the amount of bleeding was significantly lower than those of the control group （ all P 〈 0. 05 ） ; the levels of 3-NT and MDA of the observation were significantly lower and the levels of SOD and GSH were signifi- cantly higher than those of the control group （ all P 〈 0. 05 ） ; the levels of AHI, ODI and LAT were significantly decreased and the LSa（ O2 ） level was significantly increased in two group after operation （ all P 〈 0. 05 ） , and the each index of the

关 键 词：鼻内窥镜 低温等离子射频消融术 扁桃体联合腺样体切除术 小儿鼾症 过敏性鼻炎 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]