【摘要】 目的观察鼻内镜下低温等离子射频消融术治疗儿童OSAHS的临床效果。方法选择80例OSAHS患儿,按入院时间顺序编号,奇数号为观察组、偶数号为对照组,每组各40例,对照组予传统扁桃体剥离术与鼻内镜下腺样体切除术,观察组实施鼻内镜下低温等离子射频消融术。观察2组患儿手术时间、术中出血量、伪膜脱落时间及术后24、48、72 h疼痛视觉模拟量表（VAS）评分,对比手术前后通气功能指标变化,包括氧减饱和指数（ODI）、呼吸紊乱指数（AHI）、最长呼吸暂停时间（LAT）、最低夜间血氧饱和度（LSaO₂）、血氧饱和度<90%时间所占睡眠时间百分比（SLT90%）,并比较2组患儿术后出血发生率。结果与对照组比较,观察组手术时间较短、术中出血量较少（P均<0.05）,2组伪膜脱落时间比较差异无统计学意义（P>0.05）。2组患儿术后VAS评分均随时间延长而降低（P均<0.017）,其中观察组的术后24、48、72 h VAS评分均低于对照组（P均<0.05）。术后2组患儿的ODI、AHI、LAT、SLT90%均低于术前（P均<0.05）、LSaO₂高于术前（P <0.05）;术后观察组患儿的ODI、AHI、LAT、SLT90%均低于对照组,LSaO₂高于对照组（P均<0.05）。2组患儿术后出血发生率比较差异无统计学意义（P> 0.05）。结论鼻内镜下低温等离子射频消融术治疗儿童OSAHS临床疗效良好,能有效缩短手术时间,减少术中出血,缓解术后疼痛,改善患儿通气功能。更多还原

【Abstract】 Objective To observe the clinical efficacy of low-temperature plasma radiofrequency ablation under nasal endoscope in the treatment of children with obstructive sleep apnea-hypopnea syndrome（OSAHS）. Methods Eighty children with OSAHS were selected and assigned into the observation（odd admission number, n=40） and control groups（even admission number, n=40）. In the control group, traditional tonsillectomy combined with nasal endoscopic adenoidectomy was performed, and low-temperature plasma radiofrequency ablation under nasal endoscope was conducted in the observation group. The operation time, intraoperative blood loss, time of pseudomembranous detachment and visual analogue scale（VAS） scores at postoperative 24-, 48-and 72-h were observed in two groups. The changes in the ventilation function parameters were statistically compared before and after surgery including oxygen desaturation index（ODI）, respiratory disturbance index（AHI）, the longest apnea time（LAT）, the lowest oxygen saturation at night（LSaO₂<90%）, the percentage of oxygen saturation time in sleep time（SLT90%）. The incidence of postoperative bleeding was compared between two groups. Results Compared with the control group, the operation time was significantly shorter and the intraoperative blood loss was considerably less in the observation group（both P< 0.05）. The time of pseudomembranous detachment did not significantly differ between two groups（P > 0.05）. The VAS scores were significantly decreased over time in two groups（both P < 0.017）. The VAS scores at postoperative 24-,48-and 72-h in the observation group were significantly lower compared with those in the control group（all P < 0.05）. In both groups, the ODI, AHI, LAT and SLT90% were significantly declined, whereas the LSaO₂ was considerably elevated after surgery（all P < 0.05）. Postoperatively, the ODI, AHI, LAT and SLT90% in the observation group were considerably lower, whereas the LSaO₂ was significantly higher than those in the control group（all P < 0.05）. The incidence of postoperative blood loss did not significantly differ between two groups（P > 0.05）. Conclusions Nasal endoscopic low-temperature plasma radiofrequency ablation is an efficacious treatment of pediatric OSAHS, which can effectively shorten the operation time, reduce intraoperative bleeding, relieve postoperative pain and improve the ventilation function of the OSAHS children.更多还原