The Clinical Effects Of Different Tonsillectomy Methods In The Treatment Of OSAHS In Children

Objective: To treat children with Obstructive Sleep Apnea Hypopnea Syndrome caused by hypertrophy of tonsils by different tonsillectomy.To explore the value of different scope of tonsillectomy in treatment of OSAHS children.In treating of OSAHS children with tonsill hypertrophy,the selection of surgical methods for tonsillectomy is guided.Methods: 60 cases of OSAHS children treated with simple tonsil hypertrophy as the etiology were collected,40 males and 20 females who were hospitalized in the E.N.T.department of First Affiliated Hospital of Hebei North University,dating from Aug 2017 to Aug 2018 were collected.Sixty children with tonsil hypertrophy above II degree.Adenoid obstruction of the posterior nostril is less than 1/2,examined by electric nasopharyngoscopy before surgery.The selected cases were randomly divided into three groups,A,B and C,with 20 cases in each group,and different tonsillectomy was performed in each group.Group A: taking tonsillectomy.Group B: partial removal of tonsil,the remaining tonsil tissue did not exceed the tonsil recess.Group C: partial removal of tonsils and preservation of the lower pole of tonsils.Tonsils were removed and adenoids were retained in all three groups by low-temperature plasma knife.OSA-18 scale was used to score 3 groups of children 1 day before surgery,2 weeks prior to the treatment and 6 months after the treatment.The operative time and the amount of blood loss were recorded,and the Visual Analogue Scale scores for the statistics of swallowing pain in 1-3 days after the operation.Results: OSA-18 scores were given to all 3 groups before operation,while no statistical significance was found in the difference of the total score(P>0.05).Telephone follow-up was conducted 2 weeks after the surgery.There was no significant difference in OSA-18 between the 3 groups(P>0.05).Telephone follow-up was conducted again 6 months after the operation,there was no significant difference in OSA-18 between the 3 groups(P>0.05).Compared in the same group,OSA-18 score was significantly reduced after operation.The operation time and blood loss were statistically analyzed.The operation time and blood loss in group A were significantly more than other groups,there are significant difference(P<0.01).The blood loss and operation time in groups B and C were not statistically significant(P>0.05).Postoperative VAS scores were used to the 3 groups,and the pain index of group A was higher than that of group B and C,and there were statistically significant(P<0.05 on the first day,P<0.01 on the second and third days).While the VAS scores of the children in group B and C were not statistically significant(P>0.05).No one was lost during the postoperative follow-up,and no hyperplasia of tonsils and adenoids was found.But within 10 days after surgery,there was 1 case postoperative hemorrhage in group A and group B,and no such cases in group C.Conclusion: The three kinds of tonsillectomy can solve the clinical symptoms of OSAHS children,and the treatment effect is not different.Compared with group A,group B and C had more advantages in operation time,operative blood loss and postoperative pain.To treat children OSAHS caused by simple hypertrophy of tonsils,partial tonsillectomy in groups B and C is more worthy of promotion.