鼻内镜下腺样体低温等离子消融术治疗儿童阻塞性睡眠呼吸暂停低通气综合征的效果及对其免疫功能的影响  

Effect of low-temperature plasma ablation under nasal endoscopy in the treatment of obstructive sleep apnea-hypopnea syndrome in children and its influence on their immune function

作　　者：陈健 CHEN Jian(Otolaryngology Department,Nan'an Traditional Chinese Medicine Hospital,Quanzhou 362300,China)

机构地区：[1]南安中医院耳鼻咽喉科,362300

出　　处：《中国现代药物应用》2024年第13期54-57,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨儿童阻塞性睡眠呼吸暂停低通气综合征采取鼻内镜下腺样体低温等离子消融术治疗对患者免疫功能的影响。方法将南安中医院耳鼻咽喉科2021年6月~2022年12月收治的70例儿童阻塞性睡眠呼吸暂停低通气综合征患儿随机分为对照组(n=35例)和观察组(n=35例)。对照组患儿给予鼻动力切割术治疗,观察组患儿给予鼻内镜下腺样体低温等离子消融术治疗。比较两组手术指标,手术前后免疫功能指标、疾病特异性生活质量调查表(OSA-18)评分、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_(2))、最大鼓室压差值,临床疗效、术后并发症发生情况。结果观察组术中出血量为(9.12±2.28)ml,明显少于对照组的(28.84±2.02)ml(t=38.300,P<0.05);观察组总手术时间为(19.24±5.02)min,明显短于对照组的(36.58±4.24)min(t=15.612,P<0.05)。术后2周,两组患儿的IgA、IgG、IgM、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均低于术前,且观察组IgA(1.16±0.06)g/L、IgG(9.78±0.95)g/L、IgM(1.24±0.05)g/L、CD3^(+)(60.44±3.67)%、CD4^(+)(31.11±3.18)%、CD4^(+)/CD8^(+)(1.10±0.15)低于对照组的(1.32±0.08)g/L、(10.26±1.02)g/L、(1.46±0.10)g/L、(63.63±4.23)%、(33.63±3.06)%、(1.18±0.10)(P<0.05)。术后6个月,两组患儿的OSA-18评分、AHI低于术前,LSaO_(2)及最大鼓室压差值高于术前(P<0.05);观察组术后6个月OSA-18评分(32.76±3.42)分、AHI(5.35±1.18)次/h低于对照组的(36.25±3.83)分、(7.86±1.14)次/h,LSaO_(2)(93.24±5.76)%及最大鼓室压差值(24.46±5.56)daPa高于对照组的(83.24±5.56)%、(20.48±4.45)daPa(P<0.05)。两组总有效率比较无差异(χ^(2)=0.348,P>0.05)。对照组术后并发症总发生率为17.14%,观察组术后并发症总发生率为0;观察组术后并发症总发生率低于对照组(χ^(2)=6.563,P<0.05)。结论儿童阻塞性睡眠呼吸暂停低通气综合征采用鼻内镜下腺样体低温等离子消融术治疗较鼻动力切割术更能有效缩短手术时间及�Objective To explore the effect of low-temperature plasma ablation under nasal endoscopy in the treatment of obstructive sleep apnea-hypopnea syndrome in children and its influence on their immune function.Methods 70 children with obstructive sleep apnea hypopnea syndrome were divided into a control group and an observation group according to random number table,with 35 cases in each group.Children in the control group were treated with nasal dynamic incision,and children in the observation group were treated with low-temperature plasma ablation under nasal endoscopy.Both groups were compared in terms of surgical indexes,immune function indexes,disease specific quality of life for children with obstructive sleep apnea 18 items survey(OSA-18)score,apnea hypopnea index(AHI),lowest oxygen saturation(LSaO_(2))and maximum tympanic pressure difference before and after surgery,clinical efficacy and postoperative complications.Results The intraoperative blood loss in the observation group was(9.12±2.28)ml,which was significantly less than(28.84±2.02)ml in the control group(t=38.300,P<0.05).The total operation time of the observation group was(19.24±5.02)min,which was significantly shorter than(36.58±4.24)min of the control group(t=15.612,P<0.05).2 weeks after surgery,the levels of IgA,IgG,IgM,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were lower than those before surgery;the observation group had IgA of(1.16±0.06)g/L,IgG of(9.78±0.95)g/L,IgM of(1.24±0.05)g/L,CD3^(+)of(60.44±3.67)%,CD4^(+)of(31.11±3.18)%and CD4^(+)/CD8^(+)of(1.10±0.15),which were lower than(1.32±0.08)g/L,(10.26±1.02)g/L,(1.46±0.10)g/L,(63.63±4.23)%,(33.63±3.06)% and(1.18±0.10)in the control group(P<0.05).6 months after surgery,OSA-18 score and AHI in both groups were lower than those before surgery,and LSaO_(2) and maximum tympanic pressure difference were higher than those before surgery(P<0.05).6 months after surgery,the observation group had OSA-18 score of(32.76±3.42)points and AHI of(5.35±1.18)times/h,which were lower than(36.

关 键 词：儿童阻塞性睡眠呼吸暂停低通气综合征 鼻内镜 腺样体 低温等离子消融术 免疫功能 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]