The Research On Immunity And Efficacy Of Tonsillectomy With Low-temperature Plasma For The Treatment Of OSAHS In Children

Objective As a means of treatment of obstructive sleep apnea hypopnea syndrome(OSHA),tonsillectomy with low-temperature plasma has been widely used in clinic.However,many people still have doubts about whether the immunity of patient will decline and how the efficacyis after the operation.Thus,in this study,we choose the children with obstructive sleep apnea hypopnea syndrome(OSHA)who were clinically diagnosed as simple tonsillar hypertrophy with(or without)adenoid hypertrophy to study.After partial tonsillectomy and(or)adenoidectomy with low temperature plasma radio frequency system,the changes of related immune indexes before and after operation were detected,and the related immune indexes before and after operation were used to determine the effect of operation on the immune function of the children,and the changes of sleep monitoring indexes before and after operation and the changes of OSA-18 scale score were used to evaluate the effect of operation.Method Select the children with OSAHS in our department from December 2018 to December 2019,between 3 and 12 years old,to conduct primary screening.There is no limit for men and women,exclude acute and chronic tonsillitis,adenoiditis,allergic rhinitis,sinusitis,asthma and other respiratory diseases,exclude upper respiratory tract stenosis or obstruction caused by other reasons,and those with immune system diseases or Immunodeficiency.Select out 30 patients with simple tonsillar hypertrophy and(or not)adenoid hypertrophy without absolute contraindications and treated with partial tonsillectomy and(or)adenoidectomy by low temperature plasma.Three milliliter l of peripheral venous blood were collected on the day before operation,one and three months after operation to detect humoral immune related indexes(IGA,Ig G,Ig M)and cellular immune related indexes(CD3 +,CD3 + CD4 +,CD3 + CD4 +,CD4+/CD8+).All night sleep monitoring was measured one night before operation and three months after operation.The guardian of the child filled in OSA-18 before operation and three months after operation.Statistical methods were used to analyze the data and compare the data of different time points after operation with that before operation.Result One month after operation,the level of IgA,IgG,IgM,C3 and C4 was lower than these before the operation,but the difference was not statistically significant(P >0.05).The other immune indexes had little change in different period after operation compared with that before operation,and all the difference was not statistically significant(P > 0.05).Three months after the operation,the apnea hypopnea index(AHI)decreased while the lowest blood oxygen saturation(lsao2)and the total score of OSA-18 increased,and these was all statistically significant(P < 0.05).Three months after the operation,the total score of each dimension of OSA-18 was lower than that before the operation,but there was no significant difference between the two dimensions about emotion and ability(P > 0.05),the difference between the three dimensions was statistically significant(P < 0.05).Conclusion 1.After partial tonsillectomy,the humoral and cellular immune functions of children are basically the same as before.The residual tonsil tissue can still maintain its function and maintain the preoperative immune level.The operation will not lead to the decrease of immune function.2.Through the sleep monitoring and OSA-18 scale to evaluate the children’s subjective and objective,it was found that the upper respiratory tract stenosis could be relieved,the symptoms of hypoxia could be improved,and the quality of life of the children could be improved after the operation,which indicated that partial tonsillectomy for simple tonsillar hypertrophy of children with OSAHS could achieve the treatment.3.Low temperature plasma radiofrequency tonsillectomy is an effective method for the treatment of children with OSAHS,especially for the patients with simple tonsillar hypertrophy,which can achieve the purpose of surgical treatment on the premise of retaining the physiological function of tonsil.