内镜下低温等离子射频消融术与电刀凝切术在小儿鼾症治疗中的应用分析.docVIP

内镜下低温等离子射频消融术与电刀凝切术在小儿鼾症治疗中的应用分析 　　doi：10.3969/j.issn.1007-614x.2013.20.35 　　摘 要 目的：比较低温等离子射频消融术与电刀凝切术在小儿阻塞性睡眠呼吸暂停低通气综合征（OSAHS），扁桃体及腺样体切除术中的效果差异。方法：收治小儿鼾症患者80例，行双侧扁桃体及腺样体切除术，按手术方式：低温等离子射频消融术组（A组40例），电刀凝切术组（B组40例）对比分析，两组的手术时间、术中出血量、术中镇痛药量、疼痛评分。结果：低温等离子射频消融术组（A组）的手术时间、术中出血量低于电刀凝切组（B组），差异均有统计学意义（P0.05）；术后电刀凝切组（B组）疼痛评分高于等离子刀组（A组），差异有统计学意义（P0.05）。结论：低温等离子射频消融术的疗效优于电刀凝切术，其能显著减少手术时间、术中出血量，且减轻术后疼痛。 　　关键词 低温等离子射频消融术 电刀凝切术 小儿鼾症（OSAHS） 扁桃体及腺样体切除术 　　Abstract Objective：To compare the effect difference of endoscopic radiofrequency ablation and coagulation effect of electric knife in the treatment of children with obstructive sleep apnea hypopnea syndrome by tonsillectomy and adenoidectomy.Methods：We retrospectively analysed the data on 80 children with with obstructive sleep apnea hypopnea syndrome from August 2012 to May 2013 in our hospital.According to the operation mode all the patients were divided into two groups.Group A including 40 patients received low temperature plasma radiofrequency ablation operation，and Group B including 40 patients received electric knife coagulating and cutting operation.The operation time，bleeding volume，intraoperative analgesia dosage，and pain score of two groups were compared.Results：The operation time and bleeding volume of Group A were much more lower compared with that of Group B，there were significant difference between two groups （P0.05）.After operation pain score of Group B was significantly higher than Group A （P0.05）.Conclusion：Radiofrequency ablation is more effective than electrocautery coagulation，which can significantly reduce the amount of bleeding during operation，operation time，and postoperative pain，so it is worth popularizing in primary hospitals. 　　Key words the low-temperature plasma radiofrequency ablation operation；electric knife coagulating and cutting operation；snoring children；tonsillectomy and adenoidectomy 　　小儿阻塞性睡眠呼吸暂停低通气综合征（OSAHS）主要原因为腺样体及扁桃体肥大。目前针对扁桃体及腺样体肥大有不同处理方法。既往对OSAHS患者采取传统剥离法及电刀凝切术切除扁桃体及腺样体，2012年8月开始