摘要
目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿最适合的手术方式,为临床OSAHS患儿选择适合的手术方式提供帮助。方法选取经多导联睡眠图(PSG)确诊为OSAHS的患儿120例,60例拟行低温等离子扁桃体部分切除术(部分切除组),60例拟行腭咽成型术(腭咽成型组)。比较2组患儿术前及术后生活质量及免疫功能。结果术前2组患儿生活质量受到显著影响者比例比较,差异无统计学意义(P>0.05),而行手术切除后1、6个月,2组该比例均降低,差异均有统计学意义(P<0.05)。免疫功能方面,术后1个月,2组免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平均较术前下降,但差异无统计学意义(P>0.05);术后6个月时,各指标均接近术前水平,2组同一时期相同指标比较,差异均无统计学意义(P>0.05)。术后1个月,腭咽成型组CD3^+、CD4^+水平,CD4^+/CD8^+比值均显著低于部分切除组,差异均有统计学意义(P<0.05);术后6个月,腭咽成型组CD3^+、CD4^+、CD8^+水平,CD4^+/CD8^+比值均低于部分切除组,差异均无统计学意义(P>0.05)。结论手术能显著改善OSAHS患儿的生活质量,但2种方法间免疫功能的变化无差别。
Objective To study the most suitable surgical procedure for children with obstructive sleep apnea hypopnea syndrome(OSAHS),to help patients with clinical OSAHS choose the appropriate surgical approach.Methods A total of 120 children with OSAHS diagnosed by PSG were enrolled,60 patients underwent partial cryoplasmic tonsillectomy(partial resection group),and 60 patients underwent velopharyngeal surgery(pharyngeal formation group).Preoperative and postoperative quality of life and immune function were compared between the two groups.Results There was no significant difference in the proportion of patients with significant changes in the quality of life of the two groups before operation(P>0.05),and the ratios of the two groups decreased after 1 and 6 months after surgical resection,the statistical significance(P<0.05).In terms of immune function,the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)decreased at 1 month after surgery in the two months,the differences were not statistically significant(P >0.05);at 6 months after operation,all indexes were close to the preoperative level,and there was no significant difference between the two groups in the same period(P>0.05).At 1 month after operation,the CD3^+,CD4+ and CD4^+/CD8^+ ratios in the pharyngeal formation group were significantly lower than those in the partial resection group,and the differences were statistically significant(P<0.05).At 6 months after operation,the CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+ ratios in the velopharyngeal formation group were lower than those in the partial resection group,but the differences were not statistically significant(P>0.05).Conclusion Surgery can significantly improve the quality of life of children with OSAHS,but there is no difference in immune function between the two methods.
作者
付航
吕霆
张峰
谢仕津
FU Hang;LYU Ting;ZHANG Feng;XIE Shijin(Department of ENT,the Fifth People′s Hospital of Chongqing,Chongqing 400062,China;Department of ENT,Children′s Hospital Affiliated to Medical University Of Chongqing,Chongqing 400014,China)
出处
《现代医药卫生》
2019年第1期28-30,35,共4页
Journal of Modern Medicine & Health
基金
重庆市卫生健康委员会课题项目(2015MSXM110)
作者简介
付航(1970-),主治医师,主要从事耳鼻喉方面的研究;通信作者:吕霆,E-mail:3160401@163.com
