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经鼻内镜下低温等离子射频消融术治疗小儿鼾症的临床分析

Clinical analysis of transnasal endoscopic low temperature plasma radiofrequency ablation in treatment of children with snoring

    摘要
  • 摘要:
    目的 探讨经鼻内镜低温等离子消融术治疗小儿鼾症的疗效及术后并发症。
    方法 回顾性分析278例小儿鼾症的临床资料，根据手术方式不同分为对照组128例和观察组150例，对照组采用腺样体刮除术以及双侧扁桃体剥离术治疗，观察组采用经鼻内镜低温等离子消融术治疗。比较2组围术期指标、视觉模拟疼痛量表(VAS)评分、炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、应激反应指标丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)、通气功能指标呼吸紊乱指数(AHI)、氧减指数(ODI)、最长呼吸暂停时间(LAT)、最低夜间血氧饱和度(LSaO2)、匹兹堡睡眠质量指数(PSQI)评分及并发症发生率。
    结果 观察组手术时间、症状缓解时间、住院时间均短于对照组，术中出血量少于对照组，差异有统计学意义(P<0.05)。观察组术后6、24、48、72 h的VAS评分均低于对照组，差异有统计学意义(P<0.05)。术后3 d, 观察组血清TNF-α、IL-4、IL-8水平均低于对照组，差异有统计学意义(P<0.05); 术后24 h, 观察组血清MDA低于对照组, SOD、GSH高于对照组，差异有统计学意义(P<0.05); 术后6个月，观察组AHI、ODI、LAT水平均低于对照组, LSaO2高于对照组，差异有统计学意义(P<0.05); 术后6个月，观察组PSQI评分、并发症发生率低于对照组，差异有统计学意义(P<0.05)。
    结论 经鼻内镜低温等离子消融术可降低小儿鼾症炎症因子水平，减轻应激反应，改善通气功能，提高睡眠质量，且安全性高。

     

    Abstract:
    Objective To explore the efficacy and postoperative complications of transnasal endoscopic low temperature plasma radiofrequency ablation in the treatment of children with snoring.
    Methods Clinical materials of 278 children with snoring were analyzed retrospectively, and they were divided into control group (n=128) and observation group (n=150) according to different operation methods. The control group was treated with adenoidectomy and bilateral tonsillectomy, while the observation group was treated with transnasal endoscopic low temperature plasma radiofrequency ablation. Perioperative indicators, the Visual Analogue Scale (VAS) score, inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and interleukin-8 (IL-8), stress response indicators malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH), ventilation function indicators apnea hyponea index (AHI), oxygen desaturation index (ODI), the longest apnea time (LAT) and nocturnal lowest blood oxygen saturation (LSaO2), the Pittsburgh Sleep Quality Index (PSQI) score and the incidence of complications were compared between the two groups.
    Results In the observation group, the operation time, symptom relief time and hospital stay were significantly shorter than those in the control group, while the intraoperative bleeding volume was significantly less than that in the control group (P<0.05). The VAS scores of the observation group at 6, 24, 48 and 72 h after operation were significantly lower than those of the control group (P<0.05). At 3 days after operation, serum TNF-α, IL-4 and IL-8 levels in the observation group were significantly lower than those in the control group (P<0.05); at 24 hours after operation, serum MDA level in the observation group was significantly lower than that in the control group, while the levels of SOD and GSH were significantly higher than those in the control group (P<0.05); at 6 months after operation, AHI, ODI and LAT in the observation group were significantly lower than those in the control group, while the LSaO2 was significantly higher than that in the control group (P<0.05); at 6 months after surgery, the PSQI score and incidence of complications in the observation group were significantly lower than those in the control group (P<0.05).
    Conclusion Transnasal endoscopic low temperature plasma radiofrequency ablation can reduce the levels of inflammatory factors, alleviate stress response, improve ventilation function, improve quality of sleep in children with snoring, and its safety is relatively high.

     

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