Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Laryngoscope. 2013 Oct;123(10):2573-7. doi: 10.1002/lary.24011. Epub 2013 Aug 5.
OBJECTIVES/HYPOTHESIS: Pediatric obstructive sleep apnea syndrome (OSAS) is a common disorder with serious clinical implications if left untreated. The recommended initial treatment for pediatric patients with obstructive sleep apnea syndrome (OSAS) is adenotonsillectomy. However, recent reports have shown variable surgical results with adenotonsillectomy in the treatment of pediatric OSAS.
Prospective, controlled study.
From April 2007 to August 2010, 24 participants were assigned alternatively to either adenotonsillectomy with pillar suturing (intervention group) or adenotonsillectomy alone (control group).
The average improvement in apnea hypopnea index (AHI) was 42.6% in the control group and 79.9% in the intervention group (P=0.037). The success rate was 50% in the control group and 91.6% in the intervention group (P=0.034). Six patients (50%) in the intervention group achieved complete resolution of pediatric OSAS, as defined by an AHI <1/hour, compared to 2 patients (16.7%) in the control group (P=0.097).
Adenotonsillectomy with pillar suturing showed significant improvement in treating pediatric patients with OSAS compared to adenotonsillectomy alone. The procedure is simple and safe.
目的/假设：小儿阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见疾病，如果不加以治疗，会产生严重的临床后果。对于患有阻塞性睡眠呼吸暂停综合征（OSAS）的儿科患者，推荐的初始治疗方法是腺样体扁桃体切除术。然而，最近的报告显示，腺样体扁桃体切除术在治疗小儿 OSAS 方面的手术结果存在差异。
前瞻性、对照研究。
从 2007 年 4 月至 2010 年 8 月，24 名参与者被交替分配到腺样体扁桃体切除术加柱缝合（干预组）或单纯腺样体扁桃体切除术（对照组）。
对照组的呼吸暂停低通气指数（AHI）平均改善率为 42.6%，干预组为 79.9%（P=0.037）。对照组的成功率为 50%，干预组为 91.6%（P=0.034）。干预组有 6 名患者（50%）达到了小儿 OSAS 的完全缓解，定义为 AHI<1/小时，而对照组只有 2 名患者（16.7%）（P=0.097）。
与单纯腺样体扁桃体切除术相比，腺样体扁桃体切除术加柱缝合在治疗小儿 OSAS 方面有显著改善。该手术操作简单，安全。
4 级。
