微创医学

目的探讨射频消融术联合超声雾化治疗儿童腺样体肥大的临床疗效。方法选择78例腺样体肥大患儿为研究对象，采用随机数字表法分为常规组（n=39）和联合组（n=39）。常规组给予单纯射频消融术治疗，联合组给予射频消融术联合布地奈德+糜蛋白酶超声雾化治疗。比较两组患儿的临床疗效及不良反应发生情况，治疗前后症状积分和血清炎症指标水平。结果联合组患儿的临床疗效优于常规组，差异有统计学意义（P＜0.05）。治疗前，两组患儿的打鼾、鼻塞、张口呼吸、呼吸暂停症状积分差异均无统计学意义（均P＞0.05）；治疗后，两组患儿的各项症状积分均明显降低，且联合组低于常规组，差异均有统计学意义（均P＜0.05）。联合组患儿的不良反应总发生率明显低于常规组，差异有统计学意义（P＜0.05）。治疗前，两组患儿的血清CRP、TNF-α、IL-6水平差异均无统计学意义（均P＞0.05）；治疗后，两组患儿的血清CRP、TNF-α、IL-6水平均明显降低，且联合组低于常规组，差异均有统计学意义（均P＜0.05）。结论射频消融术联合超声雾化治疗儿童腺样体肥大的临床疗效显著，有效促进炎症消退，减轻患儿腺样体肥大症状，降低不良反应发生风险，值得临床推广应用。

Objective To investigate the clinical efficacy of radiofrequency ablation combined with ultrasonic gas-atomization in the treatment of adenoid hypertrophy in children. Methods A total of 78 children with adenoid hypertrophy were selected as research objects and divided into conventional group (n=39) and combination group (n=39) by the random number table method. The conventional group was treated with radiofrequency ablation alone, and the combination group was treated with radiofrequency ablation combined with budesonide + chymotrypsin ultrasonic gas-atomization. The clinical efficacy, occurrence of adverse reactions, symptom score and serum inflammatory index level were compared between the two groups. Results The clinical efficacy of the combination group was better than that of the conventional group, with statistically significant difference (P＜0.05). Before treatment, there were no statistically significant differences in snoring, nasal obstruction, mouth breathing and apnea symptom scores between the two groups (all P＞0.05). After treatment, the scores of symptoms in both groups were significantly reduced, and those of the combination group were lower than those of the conventional group, with statistically significant differences (all P＜0.05). The total incidence of adverse reactions in the combination group was significantly lower than that in the conventional group, and the difference was statistically significant (P＜0.05). Before treatment, there were no significant differences in serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) between the two groups (all P＞0.05). After treatment, the levels of serum CRP, TNF-α and IL-6 in the two groups were significantly decreased, and those in the combination group were lower than those in the conventional group, with statistically significant differences (all P＜0.05). Conclusion Radiofrequency ablation combined with ultrasonic gas-atomization in the treatment of adenoid hypertrophy in children has significant clinical efficacy, effectively promoting the regression of inflammation, reducing the symptoms of adenoid hypertrophy in children, and reducing the risk of adverse reactions, which is worthy of clinical promotion and application.