山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (1): 1-4.doi: 10.6040/j.issn.1673-3770.0.2014.334

• 睡眠呼吸障碍性疾病 •    下一篇

超声刀在治疗儿童阻塞性睡眠呼吸暂停低通气综合征中的应用

李军政1, 高翔1, 吴盖珍1, 陈莎1, 王洁1, 田文栋2, 李湘平2   

  1. 1. 东莞市第五人民医院耳鼻咽喉-头颈外科, 广东 东莞 523900;
    2. 南方医科大学南方医院耳鼻咽喉-头颈外科, 广东 广州 510515
  • 收稿日期:2014-10-08 出版日期:2015-02-16 发布日期:2015-02-16
  • 通讯作者: 田文栋。E-mail:jzli2008@163.com E-mail:jzli2008@163.com
  • 作者简介:李军政。E-mail:279780846@qq.com
  • 基金资助:
    广东省自然科学基金(10151051501000068)

Application of harmonic scalpel in children with obstructive sleep apnea and hyponea syndrome

LI Jun-zheng1, GAO Xiang1, WU Gai-zhen1, CHEN Sha1, WANG Jie1, TIAN Wen-dong2, LI Xiang-ping2   

  1. 1. The Fifth People's Hospital of Dongguan, Dongguan 523900, Guangdong, China;
    2. Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
  • Received:2014-10-08 Online:2015-02-16 Published:2015-02-16

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摘要： 目的 探讨超声刀辅助下手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的可行性。方法 将38例入选儿童OSAHS患者分为A、B两组,A组(18例)用超声刀辅助下手术,B组(20例)采用传统方法手术,对术中出血量、手术时间、术后疼痛程度、术后伤口愈合情况及术后出血等几个方面进行对照观察研究。结果 术中出血量、手术时间及术后出血概率超声刀组较传统手术组明显减少,差异有统计学意义。超声刀术组与传统手术组在创面白膜生成及脱落时间、术后切口生长情况及术后疼痛方面差异无统计学意义。结论 超声刀辅助手术治疗儿童OSAHS具有微创、安全及可行性等特点,是一种治疗儿童OSAHS较好的方法。

关键词: 多导睡眠监测, 扁桃体切除术, 睡眠呼吸暂停,阻塞性, 儿童, 腺样体切除术, 超声刀

Abstract: Objective To investigate the effectiveness of harmonic scalpel assisted adenotonsillectomy in the treatment of children with obstructive sleep apnea and hyponea syndrome(OSAHS). Method 38 cases of children with OSAHS were randomly divided into ultrasonic scalpel group (group A, 18 cases) and control group (group B, 20 cases). The adenotonsillectomy was operated with harmonic scalpel in group A, but without in group B. The blood loss, the operation time, postoperative pain, the condition of wounds were compared between the two groups. Results The operative blood loss, operation time, incidence of postoperative hemorrhage of the group A were much less than those of the group B, while no difference in postoperative pain and condition of wounds were noted between the two groups. Conclusion The application of harmonic scalpel in adenotonsillectomy for children with OSAHS is safe, efficient and feasible.

Key words: Harmonic scalpel, Polysomnography, Obstructive sleep apnea hypopnea syndrome, Tonsillectomy, Pediatric, Adenoidectomy

中图分类号: 

  • R766.9
[1] Guilleminault C, Quo S D. Sleep-disordered breathing. A view at the new Millennium[J]. Dent Clin North Am, 2001, 45(4):643-656.
[2] Tapia I E, Marcus C L. Newer treatment modalities for pediatric obstructive sleep apnea[J]. Paediatr Respir Rev, 2013, 14(3):199-203.
[3] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉科学分会.儿童阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案(乌鲁木齐)[J].中华耳鼻咽喉头颈外科杂志,2007,42(2):83-84. Editorial Board of Chinese Journal of Otorhinolary. Chinese Otorhinolaryngology of Chinese Medical Ass. Draft of guidelines for the diagnosis and treatment of pediatric sleep apnea hypopnea syndrome (Urumqi)[J]. Chin J Otorhinolaryngology Head Neck Surg, 2007, 42(2):83-84.
[4] Kemal O. Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial[J]. Eur Arch Otorhinolaryngol, 2012, 269(5):1533-1536.
[5] Tan H L, Gozal D, Kheirandish-Gozal L. Obstructive sleep apnea in children: a critical update[J]. Nat Sci Sleep, 2013, 5(5):109-123.
[6] Ali N S, Ikram M, Akhtar S, et al. Harmonic scalpel versus electrocautery tonsillectomy: a comparative study in adult patients[J]. J Pak Med Assoc, 2011, 61(3):256-259.
[7] Ramos S D, Mukerji S, Pine H S.Tonsillectomy and adenoidectomy[J]. Pediatr Clin North Am, 2013, 60(4):793-807.
[8] Alexander N S, Schroeder J W Jr. Pediatric obstructive sleep apnea syndrome[J]. Pediatr Clin North Am, 2013, 60(4):827-840.
[9] Ribeiro G H, Kerr L M, Haikel R L, et al. Modified radical mastectomy: a pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel[J]. Int J Surg, 2013,11(6):496-500.
[10] 周婕,翟锦明,陈观贵,等.超声刀在扁桃体切除手术中的应用[J].中华耳鼻咽喉头颈外科杂志,2012,47(4):324-326. ZHOU Jie, ZHAI Jinming, CHEN Guangui, et al. Application of ultracision-harmonic scalpel for tonsillectomy[J]. Chin J Otorhinolaryngology Head Neck Surg, 2007, 42(2):83-84.
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