WEBVTT00:00:02.000 --> 00:00:04.900腺样体肥大是否需要做手术呢00:00:05.080 --> 00:00:08.260今天就给大家详细的讲解一下00:00:09.360 --> 00:00:11.360从以下几个方面来讲00:00:11.360 --> 00:00:12.160第一00:00:12.280 --> 00:00:14.380不需要做手术的情况00:00:14.600 --> 00:00:16.900第二需要做手术的情况00:00:16.960 --> 00:00:19.860第三手术相关的说明00:00:19.920 --> 00:00:23.140第四手术的风险与恢复00:00:23.360 --> 00:00:25.980第五保守治疗的方法00:00:27.920 --> 00:00:28.480第一00:00:28.480 --> 00:00:30.700不需要做手术的情况00:00:31.640 --> 00:00:33.180生理性的肥大00:00:33.440 --> 00:00:35.800儿童期的暂时性肥大00:00:35.800 --> 00:00:38.460儿童在成长的过程当中00:00:38.680 --> 00:00:40.480腺样体自然的肥大00:00:40.480 --> 00:00:44.700通常在青春期后会逐渐的缩小00:00:45.240 --> 00:00:46.900是不需要手术的00:00:47.440 --> 00:00:49.940没有症状的轻微的肥大00:00:50.080 --> 00:00:51.720如果腺样肌肥大00:00:51.720 --> 00:00:54.900未引起呼吸或者是睡眠的障碍00:00:55.120 --> 00:00:56.820可以观察等待00:00:56.880 --> 00:00:59.300不立即采取手术的治疗00:01:00.600 --> 00:01:04.820症状较轻的有轻微的鼻塞和打鼾00:01:05.040 --> 00:01:08.620对于偶尔鼻塞和轻微打鼾的儿童00:01:08.680 --> 00:01:10.420可能不需要手术00:01:10.600 --> 00:01:14.420可通过药物和生活方式调整来管理00:01:14.840 --> 00:01:16.900没有明显的呼吸困难00:01:16.960 --> 00:01:20.200如果孩子没有出现明显的呼吸困难00:01:20.200 --> 00:01:21.900或者是睡眠障碍00:01:22.000 --> 00:01:24.700通常是不需要手术的干预00:01:24.880 --> 00:01:27.380可以观察症状的变化00:01:27.960 --> 00:01:29.980听力会受影响00:01:30.080 --> 00:01:33.460如果腺样体肥大没有导致听力下降00:01:33.520 --> 00:01:36.620或者是其他相关的并发症00:01:36.760 --> 00:01:39.940可以考虑非手术的治疗方案00:01:42.200 --> 00:01:44.480保守治疗有效的话00:01:44.480 --> 00:01:47.020也是不考虑用手术治疗的00:01:47.520 --> 00:01:52.220保守治疗主要指的是药物的治疗00:01:52.280 --> 00:01:54.840对于轻度的腺样体肥大00:01:54.840 --> 00:01:56.620使用抗组胺药物00:01:56.680 --> 00:01:58.980和鼻腔类固醇的喷雾00:01:59.040 --> 00:02:01.140可以有效的缓解症状00:02:01.800 --> 00:02:02.560物理治疗00:02:02.560 --> 00:02:04.340通过鼻腔冲洗00:02:04.360 --> 00:02:07.100和蒸汽吸入等物理方法00:02:07.120 --> 00:02:10.100可以缓解鼻塞和呼吸不畅00:02:10.360 --> 00:02:12.260避免手术的治疗00:02:12.800 --> 00:02:14.620生活方式的调整00:02:14.800 --> 00:02:16.540改善生活习惯00:02:16.560 --> 00:02:19.780如果如保持室内的空气湿润00:02:19.960 --> 00:02:21.540避免过敏源00:02:21.760 --> 00:02:25.300有助于减轻腺样体肥大引起的不适00:02:26.960 --> 00:02:29.620第二需要做手术的情况00:02:30.680 --> 00:02:32.520影响到了生长发育00:02:32.520 --> 00:02:34.900比如持续的鼻塞00:02:35.280 --> 00:02:36.320长期鼻塞00:02:36.320 --> 00:02:39.580导致儿童夜间睡眠质量下降00:02:39.840 --> 00:02:43.420影响生长发激素的正常的分泌00:02:43.800 --> 00:02:46.580进而可能影响身高的增长00:02:46.800 --> 00:02:48.460反复的中耳炎00:02:48.680 --> 00:02:49.880腺样体肥大呢00:02:49.880 --> 00:02:52.580可以引起反复性的中耳炎00:02:52.760 --> 00:02:54.380从而影响听力00:02:54.520 --> 00:02:58.060进而影响语言发育和学习的能力00:02:58.680 --> 00:03:00.340面部发育的异常00:03:00.480 --> 00:03:02.200长期的张口呼吸00:03:02.200 --> 00:03:05.460可以导致儿童面部骨骼发育异常00:03:05.800 --> 00:03:08.100比如上颌骨发育不足00:03:08.200 --> 00:03:10.540而出现腺样体的面容00:03:13.240 --> 00:03:15.240出现严重的并发症00:03:15.240 --> 00:03:17.220也是建议做手术的00:03:17.360 --> 00:03:20.460比如持续的鼻塞和呼吸困难00:03:20.680 --> 00:03:21.640腺样体肥大00:03:21.640 --> 00:03:24.540导致的持续的鼻塞和呼吸困难00:03:24.640 --> 00:03:27.080严重影响儿童的睡眠质量00:03:27.080 --> 00:03:28.780和日常的生活00:03:29.280 --> 00:03:32.220第二呢是反复发作的中耳炎00:03:32.760 --> 00:03:36.420肥大的腺样体阻塞了咽鼓管的通气00:03:36.520 --> 00:03:39.100导致反复发作的中耳炎00:03:39.360 --> 00:03:41.340可能导致听力下降00:03:41.680 --> 00:03:43.080影响面部发育00:03:43.080 --> 00:03:44.640长期的腺样体肥大00:03:44.640 --> 00:03:47.300可以导致儿童面部发育异常00:03:47.520 --> 00:03:49.420比如腺样体的面容00:03:49.520 --> 00:03:52.140影响外观和心理的健康00:03:53.360 --> 00:03:55.800保守治疗如果无效的话00:03:55.800 --> 00:03:58.860也是建议进行扁桃体的切除00:03:59.520 --> 00:04:00.720保守治疗无效00:04:00.720 --> 00:04:03.620指的是长期反复的感染00:04:03.720 --> 00:04:05.080如果腺样体肥大00:04:05.080 --> 00:04:08.420导致孩子长期反复上呼吸道感染00:04:08.560 --> 00:04:10.880且药物治疗没有效的时候00:04:10.880 --> 00:04:12.860可能需要手术的干预00:04:13.480 --> 00:04:15.860持续性鼻塞和呼吸困难00:04:15.880 --> 00:04:18.580当孩子出现持续性的鼻塞00:04:18.800 --> 00:04:21.580夜间打鼾或者是呼吸困难00:04:21.920 --> 00:04:25.220且保守治疗无法缓解症状的时候00:04:25.240 --> 00:04:28.060手术是一个必要的选择00:04:28.840 --> 00:04:31.440第三影响的听力和语言的发展00:04:31.440 --> 00:04:32.800如果腺样体肥大00:04:32.800 --> 00:04:35.040导致孩子出现听力下降00:04:35.040 --> 00:04:37.180或者是语言发育的迟缓00:04:37.600 --> 00:04:39.800且非手术治疗无效的时00:04:39.800 --> 00:04:42.620候是应该考虑手术治疗的00:04:44.960 --> 00:04:48.220下面讲一讲手术相关的说明00:04:48.920 --> 00:04:52.480手术的时机症状严重程度00:04:52.480 --> 00:04:56.200当腺样体肥大导致严重的呼吸障碍00:04:56.200 --> 00:04:58.940或者是频繁的感染的时候00:04:59.040 --> 00:05:01.300医生会建议做手术00:05:01.840 --> 00:05:03.200药物治疗无效00:05:03.200 --> 00:05:06.060如果长期使用药物治疗无效00:05:06.200 --> 00:05:07.600且症状持续00:05:07.600 --> 00:05:09.280影响生活质量00:05:09.280 --> 00:05:11.420可能需要考虑手术00:05:11.800 --> 00:05:14.140第三影响儿童的发育00:05:14.200 --> 00:05:16.360如果肥大的腺样体00:05:16.360 --> 00:05:18.940影响到了儿童的正常发育00:05:19.080 --> 00:05:20.960比如像听力的下降00:05:20.960 --> 00:05:23.380或者是面部发育的异常00:05:23.640 --> 00:05:25.660应该考虑手术治疗00:05:27.440 --> 00:05:28.940手术的方式呢00:05:28.960 --> 00:05:31.860有传统的腺样体切除术00:05:32.120 --> 00:05:34.440内镜下腺样体切除术00:05:34.440 --> 00:05:37.060和等离子射频消融术00:05:38.000 --> 00:05:40.120传统的腺样体切除术呢00:05:40.120 --> 00:05:43.140是通过口咽部的一个切口00:05:43.240 --> 00:05:45.720使用手术刀或者是电刀00:05:45.720 --> 00:05:48.380切除肥大的腺样体的组织00:05:48.880 --> 00:05:51.380内镜下的腺样体切除术00:05:51.440 --> 00:05:53.600是利用内窥镜的技术00:05:53.600 --> 00:05:56.140通过鼻腔进行手术00:05:56.480 --> 00:05:59.020减少对周围组织的损伤00:05:59.280 --> 00:06:01.380缩短恢复的时间00:06:01.960 --> 00:06:03.880等离子射频消融术呢00:06:03.880 --> 00:06:06.260是使用等离子射频技术00:06:06.360 --> 00:06:09.980通过射频作用去除腺样体的组织00:06:10.200 --> 00:06:11.440具有出血少00:06:11.440 --> 00:06:13.220疼痛轻的特点00:06:14.240 --> 00:06:18.340手术的效果术后的恢复期00:06:18.400 --> 00:06:20.720腺样体切除手术之后呢00:06:20.720 --> 00:06:24.280患者通常需要几天到一周的时间00:06:24.280 --> 00:06:28.540来恢复期间可能会有轻微的不适00:06:29.080 --> 00:06:30.160手术之后呢00:06:30.160 --> 00:06:33.320大多数的患者的呼吸和睡眠的质量00:06:33.320 --> 00:06:35.260得到了显著的改善00:06:35.440 --> 00:06:38.780减少了打鼾和呼吸暂停的情况00:06:39.400 --> 00:06:40.820潜在的并发症00:06:40.880 --> 00:06:43.440虽然手术效果通常良好00:06:43.440 --> 00:06:46.580但也有少数情况下可能出现出血00:06:46.920 --> 00:06:48.500感染等并发症00:06:50.200 --> 00:06:54.180手术风险与恢复手术的风险呢00:06:54.280 --> 00:06:56.260一个是出血风险00:06:56.280 --> 00:06:58.200腺样体切除手术中00:06:58.200 --> 00:07:00.240可能会出现术中出血00:07:00.240 --> 00:07:01.520或者是术后00:07:01.520 --> 00:07:04.820出血的情况需要密切的观测00:07:05.360 --> 00:07:07.460第二就是感染风险00:07:07.560 --> 00:07:11.300手术区的感染是潜在的风险之一00:07:11.320 --> 00:07:14.820需要通过抗生素预防和及时的处理00:07:15.120 --> 00:07:17.140第三是麻醉风险00:07:17.200 --> 00:07:19.260手术需要全身麻醉00:07:19.280 --> 00:07:21.160存在麻醉意外的风险00:07:21.160 --> 00:07:24.460特别是对儿童患者要格外的小心00:07:25.680 --> 00:07:29.080恢复时间术后疼痛管理00:07:29.080 --> 00:07:30.360先让其手术后00:07:30.360 --> 00:07:33.340患者可能会经历几天的疼痛00:07:33.480 --> 00:07:36.780加入适当的止痛药和护理00:07:37.080 --> 00:07:39.660饮食调整术后初期00:07:39.720 --> 00:07:41.640患者需要遵循流质00:07:41.640 --> 00:07:43.700或者是软食的饮食建议00:07:43.760 --> 00:07:46.580以减少对喉咙刺激和不适00:07:47.720 --> 00:07:50.360活动的限制为了促进恢复00:07:50.360 --> 00:07:52.280患者在术后一段时间内00:07:52.280 --> 00:07:54.560可能需要限制剧烈的运动00:07:54.560 --> 00:07:56.060和体育的劳动00:07:56.360 --> 00:07:57.480定期复查00:07:57.480 --> 00:08:00.920患者在手术后需要定期回访医生00:08:00.920 --> 00:08:02.140进行复查00:08:02.200 --> 00:08:04.360以监测恢复情况00:08:04.360 --> 00:08:07.180和及时处理任何的并发症00:08:09.240 --> 00:08:11.500保守治疗的方法有什么呢00:08:11.720 --> 00:08:12.680保守治疗呢00:08:12.680 --> 00:08:14.700主要包括药物治疗00:08:14.960 --> 00:08:16.380使用抗组胺00:08:16.680 --> 00:08:19.760和鼻用的类固醇喷雾剂00:08:19.760 --> 00:08:20.760减轻症状00:08:20.760 --> 00:08:22.000控制炎症00:08:22.000 --> 00:08:23.380改善呼吸00:08:23.560 --> 00:08:24.560生活方式等00:08:24.560 --> 00:08:26.680调整避免过敏源00:08:26.680 --> 00:08:29.020保持室内的空气流通00:08:29.120 --> 00:08:31.020减少刺激物的接触00:08:31.120 --> 00:08:33.700有助于缓解腺样体肥大的症状00:08:34.200 --> 00:08:34.920物理治疗00:08:34.920 --> 00:08:36.880通过蒸汽吸入00:08:36.880 --> 00:08:40.920鼻腔冲洗等物理方法帮助缓解鼻塞00:08:40.920 --> 00:08:43.620改善呼吸的状况00:08:44.400 --> 00:08:48.280常用的保守治疗呢有药物治疗00:08:48.280 --> 00:08:52.180使用抗阻碍药和鼻用的类固醇喷雾00:08:52.400 --> 00:08:53.840来减轻症状00:08:53.840 --> 00:08:57.180控制腺样体肥大引起的过敏反应00:08:57.400 --> 00:08:59.780第二是鼻腔的冲洗00:08:59.960 --> 00:09:02.280通过生理盐水冲洗鼻腔00:09:02.280 --> 00:09:04.420清除鼻涕和过敏原00:09:04.560 --> 00:09:07.220缓解鼻塞和呼吸不畅00:09:07.440 --> 00:09:08.400免疫疗法00:09:08.400 --> 00:09:11.620针对特定的过敏原进行脱敏治疗00:09:11.840 --> 00:09:14.320减少腺样体肥大发作频率00:09:14.320 --> 00:09:15.820和严重程度00:09:16.360 --> 00:09:18.440生活方式的调整避00:09:18.440 --> 00:09:20.720免接触已知的过敏源00:09:20.720 --> 00:09:23.060保持室内空气流通00:09:23.160 --> 00:09:25.580减少腺样体肥大的症状00:09:30.840 --> 00:09:31.700以上00:09:32.040 --> 00:09:34.560基本上给大家讲到了00:09:34.560 --> 00:09:37.100腺样体手术的时机00:09:37.160 --> 00:09:42.180还有腺样体手术的一些注意事项00:09:43.400 --> 00:09:45.740后面再补充讲解一下00:09:46.640 --> 00:09:49.740平时在临床上会遇到的一些问题00:09:50.640 --> 00:09:51.620比如00:09:52.040 --> 00:09:53.920曾经有一个小朋友00:09:53.920 --> 00:09:56.660是一个3岁6个月的宝宝00:09:56.720 --> 00:09:58.380腺样体肥大呢00:09:59.600 --> 00:10:01.220腺样体肥大00:10:02.240 --> 00:10:05.040嗯曾经用药了3个月00:10:05.040 --> 00:10:06.160去医院复查00:10:06.160 --> 00:10:08.340医生是建议手术的00:10:08.360 --> 00:10:09.860因为会打鼾00:10:10.640 --> 00:10:14.540嗯距离上次复查已经过去了一年00:10:14.720 --> 00:10:17.440这一年他的情况比去年有所好转00:10:17.440 --> 00:10:19.140鼾声没有那么大了00:10:19.160 --> 00:10:20.940偶尔还可以不打鼾00:10:21.000 --> 00:10:21.960不过有个现象00:10:21.960 --> 00:10:24.320就是有时睡觉会吐口水泡泡00:10:24.320 --> 00:10:25.420像鱼那样00:10:25.480 --> 00:10:27.100睡着了会流口水00:10:29.960 --> 00:10:31.980然后家长就问了00:10:32.160 --> 00:10:34.880孩子有腺样体面容特征了吗00:10:34.880 --> 00:10:37.760还有就是孩子有没有必要做手术00:10:37.760 --> 00:10:39.340扁桃体需不需要摘00:10:39.640 --> 00:10:42.480扁桃体特别大会有什么影响吗00:10:42.480 --> 00:10:44.580还有就是如果需要做手术00:10:44.720 --> 00:10:47.680可不可以不选择拍片而做00:10:47.680 --> 00:10:50.800鼻腔镜能否作为手术的依据00:10:50.800 --> 00:10:53.580睡着了偶尔吐口水泡泡是什么原因00:10:56.200 --> 00:10:59.500嗯然后我们来进行解答一下00:11:00.000 --> 00:11:02.280长长时间的张口呼吸00:11:02.280 --> 00:11:04.340会让孩子变丑吗00:11:05.520 --> 00:11:08.100我们常说的腺样体面容呢00:11:08.320 --> 00:11:10.840嗯指的是慢性的口呼吸00:11:10.840 --> 00:11:13.060对颌面部发育的影响00:11:13.440 --> 00:11:16.220主要表现就是上唇明显增厚00:11:16.480 --> 00:11:18.400颚硬腭高拱00:11:18.400 --> 00:11:20.620上牙裂前倾00:11:22.240 --> 00:11:25.640目前呢是没有确切的证据表明00:11:25.640 --> 00:11:27.200多长时间的口呼吸00:11:27.200 --> 00:11:28.900会引起这样的临床症状00:11:29.080 --> 00:11:31.160但是可以肯定是轻微的00:11:31.160 --> 00:11:32.480短时间的口呼吸00:11:32.480 --> 00:11:34.460并不会引起这样的病容00:11:34.720 --> 00:11:36.320和面部的畸形程度00:11:36.320 --> 00:11:38.540与口呼吸程度持续时间00:11:38.600 --> 00:11:41.580以及遗传因素等都可能有关00:11:42.120 --> 00:11:43.860孩子总体来说00:11:44.360 --> 00:11:46.000重度的阻塞00:11:46.000 --> 00:11:48.380持续时间并不算太长00:11:48.440 --> 00:11:49.640尽管这一年来00:11:49.640 --> 00:11:52.460可能多数时候都存在口呼吸现象00:11:52.480 --> 00:11:54.260但是程度不重00:11:54.520 --> 00:11:55.360时间不长00:11:55.360 --> 00:11:56.720气流的充气作用00:11:56.720 --> 00:11:58.880还不至于达到影响颌面发育00:11:58.880 --> 00:12:00.020畸形的程度00:12:00.640 --> 00:12:02.280但是需要注意的是00:12:02.280 --> 00:12:03.660孩子呢00:12:04.040 --> 00:12:07.440照片见双侧的扁桃体接近中线00:12:07.440 --> 00:12:08.360近3度打00:12:08.360 --> 00:12:10.660明显阻塞了口咽部的气道00:12:11.240 --> 00:12:13.840然后拍的鼻咽侧位片00:12:13.840 --> 00:12:16.480以及内镜检查也明确腺样体较肥大00:12:16.480 --> 00:12:18.740堵塞了大部分的后鼻孔气道00:12:19.760 --> 00:12:20.800综合来看呢00:12:20.800 --> 00:12:22.800那个小这个小朋友的上期的堵塞00:12:22.800 --> 00:12:24.060还是比较明显00:12:24.160 --> 00:12:25.800推测即便随着成长00:12:25.800 --> 00:12:27.000症状有所缓解00:12:27.000 --> 00:12:29.400但是腺样体的占位程度00:12:29.400 --> 00:12:31.780并未达到可以忽略的程度00:12:31.880 --> 00:12:34.180堵塞的情况会仍然存在00:12:34.400 --> 00:12:37.060那什么情况下要考虑手术切除呢00:12:37.160 --> 00:12:39.640也就是上气道持续堵塞00:12:39.640 --> 00:12:42.560除了会影响吞咽或者是呼吸00:12:42.560 --> 00:12:44.120导致音质改变之余00:12:44.120 --> 00:12:47.760也可能会长期影响长期的慢性缺氧00:12:47.760 --> 00:12:49.780影响孩子注意力正常发育00:12:50.200 --> 00:12:53.100且预计保守治疗效果不佳00:12:53.240 --> 00:12:56.500此时适时的接受手术治疗00:12:56.560 --> 00:13:00.060对孩子的成长会大有获益的00:13:00.160 --> 00:13:01.960如果家人也有意愿00:13:01.960 --> 00:13:03.620可以考虑手术切除00:13:04.240 --> 00:13:05.040而扁桃体00:13:05.040 --> 00:13:07.580腺样体同属于淋巴结的内环00:13:07.640 --> 00:13:09.280单纯的切除腺样体后00:13:09.280 --> 00:13:10.480扁桃体有很大的概率00:13:10.480 --> 00:13:12.020会代偿性的增生00:13:12.440 --> 00:13:15.120在故有非大的基础上00:13:15.120 --> 00:13:17.580造成口咽层面的进一步阻塞00:13:17.720 --> 00:13:21.400而仍会影响吞咽通气及发音质量00:13:21.400 --> 00:13:22.940后期存在00:13:23.000 --> 00:13:26.300还要接受一次扁桃体切除的风险00:13:26.400 --> 00:13:29.560所以说如果接触手术的话00:13:29.560 --> 00:13:32.300建议是降几个扁桃体同时接触的00:13:33.520 --> 00:13:34.960这种手术呢00:13:34.960 --> 00:13:36.920一般三甲医院的耳鼻喉科00:13:36.920 --> 00:13:39.140就可以成熟的开展这类手术00:13:39.200 --> 00:13:41.160通常大概半个小时左右就00:13:41.160 --> 00:13:42.140可以完成00:13:42.160 --> 00:13:44.060是不需要过分的担心的00:13:44.440 --> 00:13:46.840那如果要做腺样体切除的手术00:13:46.840 --> 00:13:48.580需要做哪些检查呢00:13:48.880 --> 00:13:50.160腺样体切除术呢00:13:50.160 --> 00:13:52.360可能会要求做一些相关的检查00:13:52.360 --> 00:13:55.300重新评估一下腺样体的大小00:13:55.800 --> 00:13:56.360嗯00:13:56.360 --> 00:14:00.340然后如果是有条件做多导睡眠监测00:14:00.360 --> 00:14:02.720建议睡前完善睡眠监测00:14:02.720 --> 00:14:04.680来直观的评估术前00:14:04.680 --> 00:14:06.360孩子的睡眠堵塞情况00:14:06.360 --> 00:14:07.500及其远程度00:14:07.520 --> 00:14:09.800没有条件做睡眠监测的话00:14:09.800 --> 00:14:13.100也可以做垫底的鼻咽镜检查00:14:13.120 --> 00:14:14.720而无需影像学检查00:14:14.720 --> 00:14:16.780拍片并不是必须的00:14:17.040 --> 00:14:19.300孩子为什么睡觉会吐泡泡呢00:14:19.320 --> 00:14:20.720一般吐口水的原因00:14:20.720 --> 00:14:22.540是因为上气道阻塞00:14:22.560 --> 00:14:26.020而有气流经口进出的现象00:14:26.440 --> 00:14:27.880要意味着孩子睡觉时00:14:27.880 --> 00:14:30.020存在一定程度的口呼吸00:14:30.160 --> 00:14:31.920这时尖口的气流震荡00:14:31.920 --> 00:14:35.160口腔里分泌出流的唾液粘液00:14:35.160 --> 00:14:37.260就会形成细碎的泡沫00:14:37.640 --> 00:14:41.440这种现象会在术后上气道阻塞解除00:14:41.440 --> 00:14:44.140尖口呼吸改善而缓解至消失00:14:48.840 --> 00:14:51.980有些医院做不了睡眠监测怎么办呢00:14:52.160 --> 00:14:53.520如果有睡眠监测呢00:14:53.520 --> 00:14:54.620是最好的00:14:54.720 --> 00:14:57.180术前术后可以有个直观的对比00:14:57.200 --> 00:14:59.740如果是当地医院做不了也没有关系00:15:00.000 --> 00:15:01.060嗯00:15:02.560 --> 00:15:04.900可以术前检查一下鼻咽部00:15:05.160 --> 00:15:07.480有助于对即将要切除的相机00:15:07.480 --> 00:15:10.380有个更直观改进的认识00:15:10.440 --> 00:15:11.320评估手段呢00:15:11.320 --> 00:15:13.580一般做一个电子的鼻咽镜00:15:13.840 --> 00:15:14.940就差不多了00:15:15.520 --> 00:15:18.460而且具有直观快捷没有辐射的优势00:15:18.480 --> 00:15:18.840以上00:15:18.840 --> 00:15:19.720学等检查00:15:19.720 --> 00:15:22.820不是评估腺样体的必须的检查00:15:25.560 --> 00:15:28.040这个在各个医院的术前准备中00:15:28.040 --> 00:15:29.660都不是必须要做的00:15:29.920 --> 00:15:31.680那家长还会问一个问题00:15:31.680 --> 00:15:33.520切除腺样体和扁桃体00:15:33.520 --> 00:15:35.500会影响孩子的抵抗力呢00:15:35.520 --> 00:15:36.540抵抗力吗00:15:36.760 --> 00:15:39.580其实这个手术是比较常规的00:15:41.240 --> 00:15:43.040当前的麻醉与手术的风险都00:15:43.040 --> 00:15:44.000是比较超额00:15:44.000 --> 00:15:45.660都是比较小的00:15:47.000 --> 00:15:49.600当孩子有手术切除的指征的时候呢00:15:49.600 --> 00:15:50.960切除对孩子的获益00:15:50.960 --> 00:15:52.180是远远大于00:15:52.360 --> 00:15:54.580可能对免疫力造成的影响的00:15:54.640 --> 00:15:57.060且已经有充分的临床研究表明00:15:57.120 --> 00:15:58.560扁糖体腺样体切除00:15:58.560 --> 00:16:00.900并不会影响孩子的免疫力00:16:00.920 --> 00:16:02.320孩子通气顺畅了00:16:02.320 --> 00:16:04.660反倒会改善孩子生活质量00:16:05.880 --> 00:16:07.780所以说是不需要担心的00:16:07.960 --> 00:16:10.040所以如果是你的孩子00:16:10.040 --> 00:16:12.660存在腺样体肥大的一些症状00:16:12.840 --> 00:16:15.820可以到五官科或者是儿科来就诊