低温等离子射频消融术治疗小儿鼾症的效果观察

Observation on the effect of temperature-controlled ablation radio-frequency in treatment of pediatric snoring

摘要:

目的 分析低温等离子射频消融术（TCAR）治疗小儿鼾症的临床价值。方法 选取2021年1月－2022年12月该院收治的120例小儿鼾症作为观察对象，采取随机数表法分为对照组（n = 60，接受鼻内镜下扁桃体摘除 + 腺样体切除治疗）和观察组（n = 60，采用鼻内镜下TCAR切除患者腺样体和扁桃体），比较两组患儿临床疗效、手术相关情况和睡眠质量。结果 观察组有效率为93.33%，明显高于对照组的76.67%，差异有统计学意义（P < 0.05）；观察组术中出血量少于对照组，手术时间、症状缓解时间和住院时间短于对照组，VAS低于对照组，差异均有统计学意义（P < 0.05）；术前，两组患儿魁北克睡眠问卷（QSQ）评分、艾普沃斯嗜睡量表（ESS）和儿童阻塞性睡眠呼吸暂停低通气综合征疾病特异性生活质量调查（OSA-18）量表评分比较，差异均无统计学意义（P > 0.05）；术后，观察组ESS和OSA-18量表评分低于对照组，QSQ评分高于对照组，差异均有统计学意义（P < 0.05）；术后，两组患儿QSQ评分高于术前，ESS和OSA-18量表评分低于术前，差异均有统计学意义（P < 0.05）；观察组术后并发症发生率为1.67%，明显低于对照组的11.67%，差异有统计学意义（P < 0.05）。结论 采用鼻内镜下TCAR切除扁桃体和腺样体治疗小儿鼾症，相比于传统术式，有利于提高临床疗效，可进一步改善患儿通气功能，减轻患儿痛苦，缩短症状缓解时间，改善患儿睡眠质量和生活水平，减少术后并发症发生风险。

Abstract:

Objective To analyze the clinical value of temperature-controlled ablation radio-frequency (TCAR) as a surgical option for the treatment of pediatric snoring.Method This study selected 120 children with snoring from January 2021 to December 2022 for observation. They were divided into the control group (n = 60, receiving tonsil removal+nasal underopia gland scraping therapy) and the observation group (n = 60, using TCAR to remove patients with gland samples and tonsils) using a random number table method. The clinical efficacy, surgery-related situation and sleep quality were compared.Results The effective rate of observation group was 93.33%, which was significantly higher than 76.67% of the control group. The intraoperative blood loss in the observation group was less than that in the control group, the operation time, symptom remission time and hospital stay were shorter, and the VAS was lower than those in the control group, with statistical significance (P < 0.05). There was no statistically significant difference in the comparison of Quebec sleep questionnaire (QSQ) score, Epworth sleepiness scale (ESS), and disease specific quality of life for children with obstructive sleep apnea 18 items survey (OSA-18) between the two groups of patients before surgery (P > 0.05); The postoperative ESS and OSA-18 of the observation group were lower than those of the control group, while the QSQ score was higher than that of the control group, with statistical significance (P < 0.05). After surgery, the QSQ scores of the two groups were higher than before surgery, while the ESS and OSA-18 of the two groups were lower than before surgery, with statistical significance (P < 0.05). The postoperative complications in the observation group (1.67%) was lower than that of the control group (11.67%), with statistical significance (P < 0.05).Conclusion Compared with traditional surgery, TCAR for tonsillectomy and adenoidectomy in children with snoring can improve clinical efficacy, further improve ventilation capacity, reduce patient pain, shorten symptom relief time, improve sleep quality and living standards, and reduce the risk of postoperative complications.