鼻内镜下低温等离子射频消融术治疗儿童鼾症的疗效及术后反应观察

Effect and postoperative reaction of nasal endoscopic low temperature plasma radiofrequency ablation on children with snoring

摘要:

目的 探讨鼻内窥镜下低温等离子射频消融术对儿童鼾症患者应激反应及通气功能的影响。 方法 选择2013年5月-2015年5月接受手术治疗的儿童鼾症患者104例为研究对象，采用随机数字表法分为实验组和对照组各52例，实验组患者接受鼻内窥镜下低温等离子射频消融术，对照组接受腺样体刮除术以及扁桃体剥离术。比较两组患者的手术情况、术后疼痛程度、应激反应程度以及通气功能指标。结果 ①手术指标：实验组患者手术时间、术后疼痛时间、症状缓解时间和术中出血量均明显低于对照组（P <0.05）；②疼痛程度：术后6、24、48和72 h时，实验组患者的视觉模拟疼痛评分（VAS）评分均明显低于对照组（P <0.05）；③应激反应：术后24 h时，实验组患者的血清丙二醛（MDA）、8-异前列腺素（8-isoPG）和硝基酪氨酸（3-NT）含量明显低于对照组，超氧化物歧化酶（SOD）、谷胱甘肽（GSH）含量明显高于对照组（P <0.05）；④通气功能：术后6个月，实验组呼吸紊乱指数（AHI）和氧减指数（ODI）、血氧饱和度小于90%时间所占睡眠时间百分比（SLT90%）和最长呼吸暂停时间（LAT）明显低于对照组，最低夜间血氧饱和度（LSaO2）明显高于对照组（P <0.05）。结论 鼻内窥镜下低温等离子射频消融术能够减小手术创伤、缓解术后疼痛和应激反应、改善通气功能，是治疗儿童鼾症理想的手术方法。

Abstract:

Objective To study the effect and postoperative reaction of nasal endoscopic low temperature plasma radiofrequency ablation on children with snoring. Methods 104 cases with snoring received surgical treatment from May 2013 to May 2015 were divided into experimental group and control group. The experimental group patients received nasal endoscopic low temperature plasma radiofrequency ablation, the control group received adenoidectomy curettage combined with tonsillectomy. Then the surgery condition, postoperative pain, stress response and ventilation function were compared between the two groups. Results Operation indicator: the experimental group operation time, postoperative pain time, symptoms remission time, intraoperative blood loss were significantly lower than the control group (P < 0.05); Pain degree: 6 h, 24 h, 48 h, 72 h after surgery, the experimental group VAS score were significantly lower than that in control group (P < 0.05); Stress reaction: 24 h after surgery, the experimental group patients serum MDA, 8-isoPG, 3-NT content were significantly lower than that in control group, SOD, GSH content were significantly higher than that in control group (P < 0.05); Ventilation function: 6 months after surgery, the experimental group AHI, ODI, SLT90%, LAT were significantly lower than that in control group, LSaO2 were significantly higher than that in control group (P < 0.05). Conclusion Nasal endoscopic low temperature plasma radiofrequency ablation can reduce surgical trauma and relieve postoperative pain and stress reaction, improve ventilation function, it's an ideal operative method for the treatment of children with snoring.