不同术式治疗儿童阻塞性睡眠呼吸暂停低通气综合征比较研究.docVIP

不同术式治疗儿童阻塞性睡眠呼吸暂停低通气综合征的比较研究 　　[摘要] 目的 比较不同术式治疗儿童阻塞性睡眠呼吸暂停低通气综合征的效果。 方法 将80例阻塞性睡眠呼吸暂停低通气综合征患儿根据治疗方法的不同分为治疗组与对照组各40例，对照组采用传统手术治疗，治疗组采用内镜下腺样体和（或）扁桃体切除手术治疗，比较两组的临床疗效及治疗前后血清瘦素含量的变化。 结果 治疗组与对照组的总有效率分别为97.5%和87.5%，差异有统计学意义（P0.05）。治疗组术后出血的发生率为5.0%（2/40），明显低于对照组的17.5%（7/40），差异有统计学意义（P0.05）。治疗组与对照组治疗后血清瘦素含量均明显下降，与治疗前比较，差异有统计学意义（P0.05），且治疗组较对照组下降明显，两组间差异有统计学意义（P0.05）。 结论 内镜手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征有更好的效果，可以改善血清瘦素水平，值得临床推广应用。 　　[关键词] 儿童；瘦素；阻塞性睡眠呼吸暂停低通气综合征 　　[中图分类号] R725.6 [文献标识码] B [文章编号] 1674-4721（2014）04（a）-0186-03 　　[Abstract] Objective To compare the therapeutic effect of different operating method for the treatment of obstructive sleep apnea hypopnea syndrome in children.Methods 80 cases of children with obstructive sleep apnea hypopnea syndrome were divided into the treatment group （n=40） and control group （n=40） according to the operating method.The control group was given with the traditional operating method，the treatment group was given with the operation of adenoidectomy and/or tonsillectomy endoscopy.The clinical efficacy and serum leptin before and after treatment of the two groups was compared.Results The total effective rate in the treatment group and control group was 97.5% and 87.5% respectively，and had significant difference （P0.05）.The rate of hemorrhage in the treatment group was 5.0% （2/40），was significantly lower than 17.5% （7/40） in the control group （P0.05）.The concentration of serum leptin in two groups decreased after treatment，compared with before treatment，the difference was significant （P0.05），and between the two groups，the difference was significant （P0.05）.Conclusion The surgery by endoscopy has better effect to obstructive sleep apnea hypopnea syndrome in children，can improve the level of serum leptin and should be applied in clinic. 　　[Key words] Children；Leptin；Obstructive sleep apnea hypopnea syndrome 　　阻塞性睡眠呼吸暂停低通气综合征是临床上具有潜在危险的常见病症，多发生于儿童[1]。阻塞性睡眠呼吸暂停低通气综合征的患者脂代谢水平和血清瘦素水平有所变化[2]。多采用手术进行治疗，传统手术治疗阻塞性睡眠呼吸暂停低通气综合征的有效性在20世纪就已得到证明，但是容易产生并发症[3]