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

发布时间：2018-03-27 17:06

本文选题：高频电刀　切入点：扁桃体部分切除术　出处：《实用医学杂志》2017年21期

【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。
[Abstract]:Objective to compare the effects of partial tonsillectomy with high frequency electric knife (TTT) and complete resection (TETE) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Methods 119 patients with tonsillar hypertrophy were selected as the main cause. And diagnosed with OSAHS, Preoperative PSG examination was improved. 57 cases of TT were performed with high frequency electric knife and 62 cases were treated with te. After 5 years, the satisfaction of the patients and the frequency of respiratory tract infection were investigated. Children's OSAHS quality of life questionnaire was filled in to measure the size of residual tonsils. Results the results showed that the symptoms of respiratory obstruction were significantly relieved in all the patients, but the satisfactory degree of TT group was higher than that of te group. The main reason was that the time of returning to normal diet was short after operation. All cases did not find that the frequency of respiratory tract infection was worse than that before operation. 4 cases had hyperplasia, but there was no need for re-operation. TT group had pharyngeal dryness. Conclusion TT with high frequency electric knife can effectively eliminate the obstructive symptoms of OSAHS in children, which has the advantages of faster recovery, less oral mucosal injury, and no increase in respiratory tract infection in the long term. The ratio of re-proliferation is low, and it is worth popularizing in clinic.
【作者单位】：广西柳州市人民医院耳鼻咽喉科;
【基金】：广西壮族自治区卫生厅资助项目(编号:Z2013655)
【分类号】：R766.9

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