本文選題：高頻電刀　切入點(diǎn)：扁桃體部分切除術(shù)　出處：《實(shí)用醫(yī)學(xué)雜志》2017年21期

【摘要】：目的對比高頻電刀扁桃體部分切除術(shù)(TT)與完全切除術(shù)(TE)治療兒童阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)的中遠(yuǎn)期療效差異。方法選取119例因扁桃體肥大為主要原因并確診為OSAHS的兒童,術(shù)前完善多導(dǎo)睡眠監(jiān)測(PSG)檢查。運(yùn)用高頻電刀行TT術(shù)57例,TE術(shù)62例。5年后調(diào)查家屬對手術(shù)的滿意度及術(shù)后每年呼吸道感染的頻次,填寫兒童OSAHS生活質(zhì)量調(diào)查表(OSA-18),測量殘余扁桃體的大小。結(jié)果部分患者術(shù)后復(fù)查了PSG,問卷調(diào)查提示所有的患者呼吸阻塞的癥狀明顯緩解,但TT組的滿意程度高于TE組,主要原因是術(shù)后恢復(fù)正常飲食的時(shí)間短。所有病例均未發(fā)現(xiàn)呼吸道感染頻次較術(shù)前加重的現(xiàn)象。4例出現(xiàn)增生,但并不需要再次手術(shù)。TT組出現(xiàn)咽干、喜清嗓的比例低于TE組。結(jié)論高頻電刀行TT術(shù)可有效消除兒童OSAHS的阻塞癥狀,較TE術(shù)具有術(shù)后恢復(fù)快,口腔黏膜損傷小的優(yōu)勢,而且遠(yuǎn)期并未增加呼吸道感染的頻次,再增生比例較低,值得臨床推廣。
[Abstract]:Objective to compare the effects of partial tonsillectomy with high frequency electric knife (TTT) and complete resection (TETE) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Methods 119 patients with tonsillar hypertrophy were selected as the main cause. And diagnosed with OSAHS, Preoperative PSG examination was improved. 57 cases of TT were performed with high frequency electric knife and 62 cases were treated with te. After 5 years, the satisfaction of the patients and the frequency of respiratory tract infection were investigated. Children's OSAHS quality of life questionnaire was filled in to measure the size of residual tonsils. Results the results showed that the symptoms of respiratory obstruction were significantly relieved in all the patients, but the satisfactory degree of TT group was higher than that of te group. The main reason was that the time of returning to normal diet was short after operation. All cases did not find that the frequency of respiratory tract infection was worse than that before operation. 4 cases had hyperplasia, but there was no need for re-operation. TT group had pharyngeal dryness. Conclusion TT with high frequency electric knife can effectively eliminate the obstructive symptoms of OSAHS in children, which has the advantages of faster recovery, less oral mucosal injury, and no increase in respiratory tract infection in the long term. The ratio of re-proliferation is low, and it is worth popularizing in clinic.
【作者單位】： 廣西柳州市人民醫(yī)院耳鼻咽喉科;
【基金】：廣西壯族自治區(qū)衛(wèi)生廳資助項(xiàng)目(編號(hào):Z2013655)
【分類號(hào)】：R766.9

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