鼻窦内镜辅助下等离子低温射频消融术对腺样体肥大儿童的疗效观察  

Observation of efficacy of plasma low-temperature radiofrequency ablation under nasal sinus endoscopy in children with adenoidal hypertrophy

作　　者：陈伟章 陈凯[1] 张志雄[1] CHEN Wei-zhang;CHEN Kai;ZHANG Zhi-xiong(Department of Otolaryngology,Meizhou People's Hospital,Meizhou 514000,China)

机构地区：[1]广东省梅州市人民医院耳鼻喉科,广东梅州514000

出　　处：《实用医院临床杂志》2025年第1期126-130,共5页Practical Journal of Clinical Medicine

基　　金：梅州市医药卫生科研立项课题资助(编号:2023-B-18)。

摘　　要：目的 探究鼻窦内镜下等离子低温射频消融术对腺样体肥大患儿的作用效果。方法 选取2020年1月至2023年12月本院收治的腺样体肥大患儿102例,根据治疗方案分为观察组及对照组各51例。对照组采用动力系统腺样体切除术,观察组采用鼻窦内镜下等离子低温射频消融术。比较两组临床疗效、手术指标及术后恢复情况、鼻通气功能[氧减指数(ODI)、最长呼吸暂停时间(LAT)、呼吸紊乱指数(AHI)、最低夜间血氧饱和度(LSaO_(2))]、鼻阻力[双侧总呼气阻力、鼻腔呼吸量、鼻腔吸气量],统计并发症发生情况。结果 观察组治疗总有效率显著高于对照组,手术时间、通气恢复时间较对照组更短,术中出血量更少且疼痛程度更低(P<0.05)。术后1周,两组双侧总呼气阻力较术前均降低,鼻腔呼吸量、鼻腔吸气量较术前均升高,观察组双侧总呼气阻力显著低于对照组,鼻腔呼吸量及鼻腔吸气量明显高于对照组(P<0.05)。术后3个月,两组ODI、AHI及LAT水平较术前均降低,且LSaO_(2)水平较术前均升高(P<0.05);观察组ODI、AHI及LAT显著低于对照组,LSaO_(2)高于对照组。观察组并发症总发生率低于对照组(P>0.05)。结论 鼻窦内镜下等离子低温射频消融术治疗腺样体肥大患儿,可以显著改善术后通气功能,手术时间更短、出血量更少,具有良好的临床疗效,安全性高。Objective To explore the application effect of low temperature plasma radiofrequency tissue volume reduction(RFTVR)surgery under nasal sinus endoscopy in children with adenoidal hypertrophy.Methods One hundred and two children with adenoid hypertrophy admitted to our hospital from January 2020 to December 2023 were selected.The sick children were divided into an observation group and a control group based on treatment plans,51 in each group.The control group was treated with power system adenoidectomy.The observation group was treated with sinus endoscopic RFTVR surgery.Clinical efficacy,surgical indexes,postoper-ative recovery,nasal ventilation function estimated by oxygen desaturation index(ODI),respiratory disturbance index(AHI),longest apnea time(LAT)and lowest nocturnal oxygen saturation(LSaO_(2)),and nasal resistance estimated by bilateral total expiratory resist-ance,nasal respiration and nasal inspiratory volume were compared between the two groups.The occurrence of complications were sta-tistically analyzed.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group,with shorter operation time and ventilation recovery time,less intraoperative bleeding and lower pain(P<0.05).After one week of operation,the total bilateral expiratory resistance in both groups was decreased compared with that before operation,and the nasal breathing volume and nasal inspiratory volume were increased compared with that before operation(P<0.05).The total bilateral expiratory resistance of the observation group was significantly lower than that of the control group,and the nasal breathing volume and nasal inspiratory volume were significantly higher than that of the control group(P<0.05).After 3 months of operation,the levels of ODI,AHI and LAT in both groups were lower than those before operation,and the level of LSaO_(2) was higher than that before operation(P<0.05).The levels of ODI,AHI and LAT in the observation group were significantly lower than those in

关 键 词：腺样体肥大 鼻窦内镜 等离子低温射频消融术 鼻通气功能 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]