腺样体等离子消融术后仍有口呼吸的临床分析
Clinical analysis of Mouth breathing after Adenoid plasma ablation
韩煦 1姜振华 2马荣峰 2张翠 2范义燕 2于鲲 2任荣飞 3姜珊珊3
作者信息
- 1. 滨州医学院 山东滨州 256600
- 2. 胜利油田中心医院 山东东营 257000
- 3. 广饶县人民医院 山东东营 257300
- 折叠
摘要
目的 分析腺样体等离子消融术后仍有口呼吸的临床状况,并提供相应的诊断和治疗方法.方法 选择2017年-2022年期间接受腺样体等离子消融术治疗的1903例患儿为研究对象,收集患儿病史、体格检查、鼻内镜检查及影像学检查结果,术后对其进行随访,根据随访状况分为口呼吸组和非口呼吸组,分析腺样体等离子消融术后仍有口呼吸患儿临床特点.结果 经病因分析发现:1903例接受腺样体等离子消融术治疗患儿中,其中30例仍然存在口呼吸的情况,过敏性鼻炎/慢性肥大性鼻炎/鼻中隔偏曲为主要病因;合并过敏性鼻炎/慢性肥大性鼻炎/鼻中隔偏曲、圆枕肥大/管腺样体增生、颌面畸形、下颌后缩、拒绝行扁桃体切除导致扁桃体进一步增大、腺样体复发、气道无明显阻塞、肥胖患儿术后复发几率明显高于未合并并发症患儿,但差异无统计学意义(P＞0.05);口呼吸组呼吸暂停低通气指数(SLT90％)、呼吸暂停低通气指数(AHI)、长呼吸暂停时间(LAT)、氧减指数(ODI)指标高于非口呼吸组,口呼吸组最低血氧饱和度(LSaO2)指标高于非口呼吸组,组间比较,差异存在统计学意义(P＜0.05).结论 腺样体等离子消融术后仍有口呼吸患儿,过敏性鼻炎是最常见的基础疾病.除此之外,圆枕肥大、管腺样体增生、颌面畸形、下颌后缩以及扁桃体进一步增大等因素也可能导致口呼吸的存在.在这些患儿中,腺样体复发是一个重要的问题.早期的诊断和定期的随访对于及时发现和处理复发腺样体非常重要.
Abstract
Objective To analyze the clinical situation of Mouth breathing after Adenoid plasma ablation,and provide the corresponding diagnosis and treatment.Methods 1903 children who underwent adenoid plasma ablation between 2017 and 2022 were selected as the study subjects.The patient's medical history,physical examination,nasal endoscopy,and imaging results were collected.They were followed up after surgery and divided into oral breathing group and non oral breathing group based on the follow-up status.The clinical characteristics of children who still had oral breathing after adenoid plasma ablation were analyzed.Results The etiological analysis showed that among 1903 children who received Adenoid plasma ablation,30 still had Mouth breathing,and Allergic rhinitis/chronic hypertrophic rhinitis/deflection of Nasal septum was the main cause;Allergic rhinitis/chronic hypertrophic rhinitis/deflection of Nasal septum,hypertrophy of round pillow/hyperplasia of tubular Adenoid,maxillofacial malformation,mandibular retrusion,tonsillectomy refusal leading to further increase of tonsils,recurrence of Adenoid,no obvious airway obstruction,the recurrence rate of obese children after surgery was significantly higher than that of children without complications,but the difference was not statistically significant(P＞0.05);The Apnea-hypopnea index(SLT90％),Apnea-hypopnea index(AHI),long apnea time(LAT),oxygen reduction index(ODI)indexes in the Mouth breathing group were higher than those in the non Mouth breathing group,and the lowest blood oxygen saturation(LSaO2)index in the Mouth breathing group was higher than that in the non Mouth breathing group.The difference between the groups was statistically significant(P＜0.05).Conclusion There are still children with Mouth breathing after Adenoid plasma ablation,and Allergic rhinitis is the most common underlying disease.In addition,such factors as round pillow hypertrophy,tubular Adenoid hyperplasia,maxillofacial malformation,mandibular retrusion and further enlargement of tonsils may also lead to the existence of Mouth breathing.In these children,Adenoid recurrence is an important problem.Early diagnosis and regular follow-up are very important for timely detection and treatment of recurrent Adenoid.
关键词
腺样体等离子消融术/口呼吸/鼻炎/扁桃体切除/腺样体复发Key words
Adenoid plasma ablation/Mouth breathing/Rhinitis/Tonsillectomy/Recurrence of Adenoid引用本文复制引用
出版年
2023
NETL
NSTL
维普
万方数据