高频电刀扁桃体部分切除术与完全切除术治疗儿童OSHAS的中远期疗效对比  

The long term effectiveness of tonsillotomy vs. tonsillectomy by hypercator in treatment of obstructive sleep apnea hypopnea syndrome in children

作　　者：磨宾宇[1] 李纪辉[1] 冯海燕[1] 朱汉平[1] 肖毅[1] 陈美球[1] 

机构地区：[1]广西柳州市人民医院耳鼻咽喉科,545006

出　　处：《实用医学杂志》2017年第21期3577-3581,共5页The Journal of Practical Medicine

基　　金：广西壮族自治区卫生厅资助项目(编号:Z2013655)

摘　　要：目的对比高频电刀扁桃体部分切除术(TT)与完全切除术(TE)治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的中远期疗效差异。方法选取119例因扁桃体肥大为主要原因并确诊为OSAHS的儿童,术前完善多导睡眠监测(PSG)检查。运用高频电刀行TT术57例,TE术62例。5年后调查家属对手术的满意度及术后每年呼吸道感染的频次,填写儿童OSAHS生活质量调查表(OSA-18),测量残余扁桃体的大小。结果部分患者术后复查了PSG,问卷调查提示所有的患者呼吸阻塞的症状明显缓解,但TT组的满意程度高于TE组,主要原因是术后恢复正常饮食的时间短。所有病例均未发现呼吸道感染频次较术前加重的现象。4例出现增生,但并不需要再次手术。TT组出现咽干、喜清嗓的比例低于TE组。结论高频电刀行TT术可有效消除儿童OSAHS的阻塞症状,较TE术具有术后恢复快,口腔黏膜损伤小的优势,而且远期并未增加呼吸道感染的频次,再增生比例较低,值得临床推广。Objective To compare the long term effectiveness of tonsillotomy(TT)vs. tonsillectomy(TE)by hypercator in treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children. Methods119 children with tonsil hypertrophy were diagnosed with OSAHS and included in the study. Among them,57 children underwent TT by hypercator and 62 TE only after preoperative laboratory polysomnography(PSG). Allparticipants were interviewed 5 years after operation to assess the satisfaction of their caregivers,investigate thefrequency of respiratory infections,the rate of tonsil regrowth and evaluate their quality of life by ObstructiveSleep Apnea-18(OSA-18). Results Some of them received postoperative PSG. All parents reported alleviationof breathing obstruction,but the postoperative satisfaction in TT group was higher than TE group mainly becauseof the shorter time return to normal diet. The rate of the respiratory tract infections was not increased in all casesafter surgery. Four cases of children were observed with tonsillar regrowth,but no surgery was needed for furthertreatment. The rate of the dry throat symptoms in TT group was lower than TE group. Conclusions Tonsillotomyby hypercator can effectively eliminate the obstruction symptoms in children with OSAHS,superior to TE for itsshorter recovery period and smaller oral mucosal injury and lower rate of tonsils regrowth and it is worth to clinicalpromotion.

关 键 词：高频电刀 扁桃体部分切除术 扁桃体全切术 阻塞性睡眠呼吸暂停低通气综合征 中远期疗效 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]