中文摘要：

目的 探讨3岁以下儿童腺样体肥大手术治疗的可行性。方法 回顾性研究2 166例经全身麻醉手术治疗的腺样体肥大患儿,按年龄分为3岁以下与3~6岁两组,其中3岁以下组148例患者,3~6岁组2 018例患者。术前均行鼻内镜检查确诊为腺样体重度肥大,睡眠呼吸监测检查确诊为重度阻塞性睡眠呼吸暂停综合征。对两组患儿手术并发症、术后症状、生长发育改善情况及术后复发率进行统计分析。结果 两组患儿术中出血量无明显差异,术中副损伤、术后住院天数相近,3岁以下患儿无术后出血、感染、呼吸道梗阻发生。术后随访3年,3岁以下患儿阻塞性睡眠呼吸暂停综合征临床症状明显缓解,术后最低血氧饱和度及血清胰岛素样生长因子-1（serum insulin-like grow th factors-1,IGF-1）与术前比较明显改善,但3岁以下腺样体肥大患儿术后复发率高于3~6岁组。结论 3岁以下病情严重、保守治疗无效的腺样体肥大患儿行手术治疗是可行且必要的。

英文摘要：

Objective To assess the therapeutic effects of surgical treatment for obstructive sleep apnea/hypopnea syndrome（OSAHS） caused by adenoid hypertrophy in children. Methods Clinical data of 2 166 children（ 148 children under 3 years and 2 018 aged 3 -6 years） with OSAHS caused by adenoid hypertrophy were retrospectively reviewed. The adenoid hypertrophy was diagnosed by nasal endoscopy, and severe OSAHS was confirmed by polysomnography. The postoperative complications, symptom improvement, the growth and development, recurrence rate were analyzed in both age groups. Results There were no significant differences in intraoperative blood loss and secondary injury, length of hospital stay between two age groups. No bleeding, infection and airway obstruction occurred in under 3 years group. After 3 years of postoperative follow-up, the clinical symptoms of OSAHS were significantly alleviated, and the low oxygen saturation and serum insulin-like growth factors-1 （ IGF-1 ） levels were significantly improved in children under 3 years, but the recurrence rate was higher than that in children aged 3 -6 years. Condusion When conservative treatment is invalid, surgical treatment is feasible and necessary for children under 3 years with OSAHS caused by adenoid hypertrophy.