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目的通过对手术前后阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患儿进行脉氧监测,探讨单纯扁桃体切除、单纯腺样体切除、腺样体伴扁桃体全部切除3种术式对OSAHS的手术疗效。方法选取由标准多道睡眠监测(polysomnography,PSG)确诊符合儿童OSAHS诊断的患儿120例,随机分为单纯扁桃体切除组(A组)、单纯腺样体切除组(B组)、腺样体伴扁桃体全部切除组(C组),每组40例。分别将术前、术后6个月对患儿进行分别脉氧监测,监测平均血氧饱和度(mean oxygen saturation,MSpO_2)、最低血氧饱和度(lowest oxygen saturation,LSpO_2)、氧减指数(oxygen desaturation index,ODI)及脉率差(整夜脉率最高值-整夜脉率最低值),以此评估不同治疗的疗效。结果 3组患儿术后ODI、脉率差均较术前降低,差异有统计学意义(P<0.05);3组患儿术后LSpO_2、MSpO_2均较术前提高,差异有统计学意义(P<0.05);术后6个月3组比较,C组患儿MSpO_2、LSpO_2较A、B组患儿提高,差异有统计学意义(P<0.05);ODI、脉率差较A、B组降低,差异有统计学意义(P<0.05);A、B两组MSpO_2、LSpO_2、ODI、脉率差差异无统计学意义(P>0.05)。结论单纯扁桃体切除、单纯腺样体切除、腺样体伴扁桃体全部切除3种术式均对儿童OSAHS有疗效,腺样体伴扁桃体全部切除术疗效显著。
Objective To investigate the effects of simple appendectomy, adenoidectomy alone, adenotonsillar appendectomy with three kinds of appendectomy on children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after surgery Surgical treatment of OSAHS. Methods A total of 120 children diagnosed with OSAHS diagnosed as children by standard polysomnography (PSG) were enrolled in this study. They were randomly divided into simple tonsillectomy group (A group), simple adenoid excision group (B group), adenoid With tonsillectomy group (C group), 40 cases in each group. The patients were monitored by pulse oxygenation (MAP), mean oxygen saturation (MSpO_2), lowest oxygen saturation (LSpO_2), oxygen reduction index ( oxygen desaturation index, ODI), and pulse rate difference (the highest value of nighttime pulse rate - the lowest value of nighttime pulse rate), so as to evaluate the curative effect of different treatments. Results The ODI and pulse rate difference of the three groups were significantly lower than those before operation (P <0.05). The LSpO_2 and MSpO_2 of the three groups were significantly higher than those before operation (P <0.05) P <0.05). Compared with group A and B, MSpO_2 and LSpO_2 in group C were significantly higher than those in group A and B (P <0.05) (P <0.05). There was no significant difference in MSpO_2, LSpO_2, ODI and pulse rate between groups A and B (P> 0.05). Conclusions Simple tonsillectomy, simple adenoidectomy and adenoid with tonsillectomy are effective in children with OSAHS. Adenoid with tonsillectomy has a significant effect.