一侧扁桃体加腺样体切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效观察.doc

一侧扁桃体加腺样体切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效观察[摘要] 目的：观察一侧扁桃体加腺样体切除术在治疗儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）疗效与传统双侧扁桃体加腺样体切除比较。方法：对经睡眠监测诊断为OSAHS的318例儿童，所有患者均近一年来无扁桃体炎病史，并已排除鼻中隔偏曲、鼻炎、后鼻孔狭窄、舌体肥大等其他因素所引起OSAHS。随机分为两组，一组行一侧扁桃体加腺样体切除术（简称为改良组），一组行常规双侧扁桃体加腺样体切除术（简称为对照组），术后随访6个月～2年，比较术后两组疗效差异。结果：两组在治疗儿童OSAHS无明显差异，术后随访6个月～2年发现改良组保留的一侧扁桃体极少数发生代偿性肥大，部分发生了萎缩。结论：一侧扁桃体加腺样体切除术既能保留患儿一侧扁桃体的生理功能，又能有效治疗OSAHS，是值得推广的一种手术方式。 [关键词] 阻塞性睡眠呼吸暂停低通气综合征；腺样体；扁桃体；手术 [中图分类号] R766 [文献标识码]A [文章编号]1673-7210（2008）07（b）-059-02 Effect of only one tonsilla ectomy and adenoidectomy in the children with obstructive sleep apnea hypopnea syndrome CHEN Lin,ZHANG Shu-jia,XU Heng-guang (Department of Otolaryngology,Lianyungang First People’s Hospital,Xuzhou Medical College, Lianyungang 222000,China) [Abstract] Objective:To compare the effect of only one tonsilla ectomy and adenoidectomy with the traditional operation in children with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods:318 children with OSAHS without antiaditis in the recent one year and without deflection of nasal septum, rhinitis, posterior naris stenosis, tongue body hypertrophy and etc.All cases were divided into two groups randomly, the cases with only one tonsilla ectomy and adenoidectomy was the reforming group ,the other cases was the control group. All cases were followed up from 6 months to 2 years and the efficacy of the two groups were compared. Results:There was no significant difference between the two groups.Compensatory hypertrophy occurred in the remaining tonsilla in very few cases，and also atrophy occurs in part of them. Conclusion: Only one tonsilla extirpation and adenoidectomy not only control the disease but also remain the physiologic function of the tonsilla. This modus operandi deserved to be used generally. [Key words]OSAHS;Tonsil;Adenoid tonsil;Operation 儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是指睡眠过程中频繁发生部分或全部上气道阻塞，引起低通气或通气暂停止，扰乱儿童正常通气和睡眠结构而引起的一系列病理生理变化，是儿童常见的问题，儿童OSAHS的发病率为2%～3%[1]，双侧扁桃体加腺样体切除已成为一种常规治疗手术方法。在引起打鼾和OSAHS的阻塞性原因中，扁桃