基于改良悬雍垂腭咽成形术治疗儿童OSAHS的临床研究  

Clinical study on the treatment of OSAHS in children with different surgical approaches based on H-uvulopalatopharyngoplasty

作　　者：陈志太 王胜国 周本忠 史先萍 吴飞凤 李龙巧 张泽生 周广杰 刘洋 CHEN Zhitai;WANG Shengguo;ZHOU Benzhong;SHI Xianping;WU Feifeng;LI Longqiao;ZHANG Zesheng;ZHOU Guangjie;LIU Yang(The 901st Hospital of the Joint Logistics Support Force of PLA,China,230000 Hefei)

机构地区：[1]中国人民解放军联勤保障部队第九〇一医院,合肥230000

出　　处：《实用口腔医学杂志》2024年第5期687-690,共4页Journal of Practical Stomatology

摘　　要：目的:评价采用改良悬雍垂腭咽成形术(H-UPPP)和传统手术治疗儿童阻塞性睡眠呼吸暂停综合征(OSAHS)的临床效果。方法:纳入364例接受改良悬雍垂腭咽成形术治疗的儿童OSAHS患者的医疗记录进行回顾性分析。对使用低温等离子射频技术进行双侧扁桃体摘除并结合H-UPPP的一组患者204例(A组)和仅采用低温等离子射频技术摘除扁桃体后进行传统手术的另一组患者160例(B组)进行比较分析。评估两组患者的手术持续时间、手术过程中的出血状况、术后出血的再次发生、儿童术后的疼痛感受(VAS)、伤口愈合过程中白膜的脱落时间以及客观评估指标OAHI、LSaO_(2)和主观评分ESS,同时监测并发症的发生率。结果:A组手术时间、术中出血量、术后VAS、OAHI和ESS评分均低于B组(P<0.05),术后创面白膜脱落时间、LSaO_(2)高于B组(P<0.05);术后继发出血例数、并发症组间比较,差异无统计学意义(P>0.05)。结论:在应用射频消融技术结合H-UPPP进行OSAHS治疗的过程中,手术区域可视化效果显著,操作视野清晰,临床效果更佳。Objective:To study the clinical effects of modified surgical method with H-uvulopalatopharyngoplasty(H-UPPP)and traditional surgical method in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:The clinical data of 364 pediatric patients with OSAHS were retrospectively analyzed.The patients were divided into 2 groups and treated by low-temperature plasma knife radio frequency ablation for bilateral tonsil removal combined with H-UPPP(group A,n=204)and low-temperature plasma knife radio frequency ablation only(group B,n=160)respectively.The operative time,intraoperative bleeding,postoperative secondary bleeding,VAS of pain following operation,postoperative traumatic white film shedding time,OAHI,LSaO_(2),ESS scores and complications of the 2 groups were compared.Results:In group A the operative time,intraoperative bleeding,VAS,OAHI and ESS scores were lower than those in group B(P<0.05),wile postoperative traumatic white film detachment time and LSaO_(2)were higher(P<0.05).No statistically significant difference in terms of the number of cases of postoperative secondary bleeding and complications was observed between the 2 groups(P>0.05).Conclusion:The combination of low-temperature plasma radio frequency ablation and H-UPPP for the treatment of OSAHS may provide clear intraoperative view,and may improve the treatment effects.

关 键 词：改良悬雍垂腭咽成形术 儿童阻塞性睡眠呼吸暂停低通气综合征 低温等离子刀 嗜睡 

分 类 号：R782.2[医药卫生—口腔医学] R788[医药卫生—临床医学]