鼻内镜下扁桃体腺样体等离子切除术对 重度鼾症所致发育不良的治疗效果*

Clinical effect of endoscopic plasma-adenotonsillectomy on children with physical retardation by serious sleep hypopnea*

摘要:

摘要：目的 探讨扁桃体腺样体重度肥大阻塞气道、引起睡眠鼾症而致身高和（或）体重发育不达标的患儿，进行鼻内镜下等离子扁桃体腺样体切除术后1年，其生长发育达标的情况。方法 随访因扁桃体腺样体重度肥大引起睡眠鼾症导致身高和（或）体重发育不达标的患儿47名，收集其术前病史，包括睡眠质量、有无缺氧、发育情况、精神注意力和手术情况，并记录术前和术后6个月、术后1年身高和体重达标情况，统计分析身高体重术前术后的增长情况和达标率。结果 患儿年龄2～5岁，平均月龄（48.45±11.36）个月，术前均有严重的睡眠打鼾，伴有张口呼吸和睡眠呼吸暂停41例（87.2%），白天注意力不集中35例（74.5%），进行鼻内镜扁桃体腺样体等离子切除术，术后6个月和1年身高增长平均为（6.27±1.73）和（11.88± 2.35）cm，体重增长分别为（1.96±0.42）和（3.58±0.79）kg。术后1年身高体重按标准，身高达标40例（85.11%），体重达标36例（76.60%），均达标32例（68.09%）。结论 儿童鼾症会影响患儿身高体重发育，尤其是重度阻塞，经鼻内镜扁桃体腺样体等离子切除术后，可促进恢复生长发育，有手术指征的患儿应尽早手术，以免耽误儿童黄金生长发育期。

Abstract:

Abstract: Objective To explore the height and weight compliance the one year after endoscopic plasma-adenotonsillectomy on children with physical retardation: height or weight unreach the criteria, by serious sleep hypopnea with tonsil adenoid hypertrophy obstructing airway. Methods A follow up study of clinical symptom records, sleep quality, anoxia, statures, mental concentration were observed, heights and weights before operations, the 6 months and 1 year after operations of 47 children patients with physical retardation by serious sleep hypopnea were recorded. Statistics of heights and weights were analyzed, as well as standard reaching rates. Results Among 47 children patients, aging from 2 ~ 5 years old, with an average month of (48.45 ± 11.36) months, all have symptoms of serious hypopnea, 41 of them with mouth breathing and sleep apnea (87.2%), 35 with difficulty concentrating (74.5%), their height-raises 6 months and 1 year after endoscopic plasma-adenotonsillectomy were (6.27 ± 1.73) cm and (11.88 ± 2.35) cm; weight-increases were (1.96 ± 0.42) kg and (3.58 ± 0.79) kg. According to child growth development criteria, heights of 40 cases (85.11%) and weights of 36 cases (76.60%) up to the standard line, 32 cases (68.09%) with the two both reach the standard. Conclusion Sleep hypopnea especially serious type has a great influence on children height and weight developments. Most of them should regain after instant endoscopic plasma-adenotonsillectomy. They should undergo the operation as soon as they reach surgical indications, so as not to delay the growth period of gold.