Clinical Comparative Analysis Of The Effect Of Different Operation Range Treating OSAHS In Children

Objectives:To discuss the clinical effect of the aspects of sleep, immunity, postoperative pain, postoperative bleeding, postoperative recurrence of different operation range treating OSAHS in children.Methods:Choose the clinical date of 120 cases OSAHS in children with surgery operation in ENT, Head & Neck Surgery department of Tangshan Xie-He hospital of Hebei province between January 2014 and February 2015. Patients were divided into two groups randomly,60 cases of group A and group B respectively, group A with adenoidectomy and most of the bilateral tonsils resection, group B with adenoidect-omy and partial bilateral tonsils resection. All patients with PSG check in preoperative and postoperative 3 months to observe the change of sleep index of the two groups; observe the pain of 120 cases with postoperative 1,2,3,5 days by Wong-Baker FACES Rating Scale; observe the changes of immunoglobulin with preoperative and postoperative 3 months of the two groups; observe postoperative bleeding and the hyperplasia of adenoidectomy and tonsils postoperative 1 year.Results:1. AHI (P=0.31), Apnea Index (P=0.67), The Lowest SaO2 (P=0.19), Average SaO2 (P=0.26), and the longest Apnea time (P=0.63) are compared between group A and group B in preoperative PSG monitoring, there are no statistically significant difference; postoperative 3 months compare the indicators of AHI (P=0.88), apnea index (P=0.83), the Lowest SaO2 (P=0.08), Average SaO2 (p=0.41), the longest time of Apnea (P=0.15), and sleep index between the two groups are still no statistically difference. There are significant statistically difference of the five sleep indices between preoperative and postoperative 3 months within groups.2. There is statistically significant between postoperative the first day (P=0.00), the second day (P=0.03) of group A and group B in pain; 3 days (P=0.75) and 5 days (P=0.72) postoperatively have no statistically significant difference.3. There is no statistically significant difference between the two groups of immunoglobulin (IgG, IgA and IgM) preoperative and postoperative 3 months.4. The hemorrhage rate postoperative of group A was higher than group B, but it is still need large quantity samples to further confirm.5. In the two groups, the age of 2 to 6 yeas patients’s adenoidectomy and tonsils are hyperplasia than the age of 7 to 12 years, but no patient recurred OSAHS in children..Conclusions:1. There are no statistically significant difference in five indices of post-Operative PSG monitoring and immunity about different operation range treating OSAHS In children, but surgical effect is remarkable.2. The treatment of moderate and severe OSAHS in children should use adenoidectomy and most of the bilateral tonsils resection to reduce the risk of recurrence after surgery.3. It is more appropriate of the patients of the age 7 to 12 adopt adenoidectomy and partial bilateral tonsils resection, if the children’ tonsils Ⅰ° or Ⅱ° in this stage, it were no need operation treatment and avoid the postoperative complication and surgical pain.