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目的:探讨三种腺样体手术方式治疗儿童OSAHS临床疗效。方法:对86例经多导睡眠监测(PSG)确诊的OSAHS患儿(3~l2岁)施行:全麻下经鼻内镜经口-鼻腺样体切除术、内镜辅助下射频消融术及传统的经口腺样体刮除术3术式,并对患儿进行术后的随访,观察术后夜间打鼾、鼻塞、张口呼吸等临床症状、腺样体残留等指标。结果:术后随访6~12个月。鼻内镜术后打鼾、鼻塞、张口呼吸等症状治愈率显著高于传统的腺样体刮除术(P<0.01)。传统的腺样体刮除术、鼻内镜下腺样体微波消融术,存在不同比例的腺样体残留,鼻内镜经口-鼻腺样体切除术,无腺样体残留。结论:手术切除肥大的腺样体是治疗儿童OSAHS的主要手段。鼻内镜辅助下腺样体切除术具有直视下操作、病变切除彻底、疗效明显、安全性高、创伤小及并发症少等优点。
Objective: To investigate the clinical efficacy of three kinds of adenoid surgery in the treatment of OSAHS in children. Methods: Eighty-six children with OSAHS diagnosed by polysomnography (PSG) (3 ~ 12 years old) underwent transnasal endoscopic naso-endolectomy under general anesthesia and endoscopic assisted radiofrequency ablation And traditional oral adenoid surgery three kinds of surgery, and the children were followed up after surgery to observe postoperative night snoring, nasal congestion, mouth breathing and other clinical symptoms, adenoid residue and other indicators. Results: The patients were followed up for 6 to 12 months. The cure rates of snoring, nasal obstruction, mouth breathing and other symptoms after endoscopic sinus surgery were significantly higher than those of traditional adenoid curettage (P <0.01). Traditional adenoidectomy, endoscopic adenoidectomy with microwave ablation, there are different proportions of adenoid residue, endoscopic nasolectomy, no adenoid residue. Conclusions: Surgical removal of hypertrophic adenoids is the primary treatment for OSAHS in children. Endoscopic assisted adenoidectomy with direct vision under the operation, complete removal of the lesion, the effect is obvious, high safety, less trauma and fewer complications.