会厌囊肿的微创介入治疗及临床分析

发布时间：2018-03-03 02:08

本文选题：会厌囊肿　切入点：微创介入　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析会厌囊肿在成人和婴幼儿的临床特征、早期诊断及治疗方案,比较传统支撑喉镜下会厌囊肿切除术与门诊表麻下电子喉镜引导下会厌囊肿的激光揭盖术之间的优势与劣势,根据统计学结果,为后者的临床推广提供依据。方法:收集2016年2月~2017年1月就诊于我科的会厌囊肿患者,其中住院患者20例,均采用支撑喉镜下会厌囊肿摘除、电刀止血治疗。门诊患者20例,均应用局麻下电子喉镜下半导体激光微创介入微创治疗。整理临床数据,应用SPSS 23.0软件进行统计学分析。比较二者在平均住院日、治疗费用、术中术后并发症的发生情况、术后疼痛情况、术后恢复情况、术后复发情况以及患者满意度调查。对比传统治疗方式与门诊微创介入治疗方式。结果:20例住院患者中,男性12例,女性8例,年龄在25-65岁之间。最少住院天数4天,最多住院天数9天,平均住院天数6.4天。20例门诊微创介入手术患者,男性10例,女性10例,年龄在30-65岁之间。全部为术后观察1小时即可离开。纳入标准:均经过电子喉镜明确位置,并有相应的临床症状。再经过统计学方法检验,发现会厌囊肿的发病在男女比例上无统计学差异,在术后复发方面,二者没有统计学差异。在平均住院日方面,门诊表麻微创介入治疗的患者大大短于住院全麻支持喉镜下手术的患者。在平均出血量方面,门诊表麻微创介入治疗的患者大大少于住院全麻支持喉镜下手术的患者。在患者经济负担方面,门诊表麻微创介入治疗的患者明显较住院全麻支持喉镜下手术的患者少,大大减轻了患者的经济负担。在患者满意度上,门诊表麻微创介入治疗的患者的平均满意程度较住院全麻支持喉镜下手术的患者高。结论:相比于住院全麻下支撑喉镜下会厌囊肿的手术治疗,门诊表麻下电子喉镜下应用半导体激光基于会厌囊肿揭盖术原理对会厌囊肿进行微创介入治疗的方法具有如下优势:a、费用低廉,大大节约患者就医费用,大大节约医疗成本;b、开展简单,了解原理并能熟练运用后,大多数医院拥有相应的设备便可以开展此种治疗方法;c、患者痛苦小,就医满意度高;d、手术并发症少,相对于全麻下支撑喉镜下的手术,对于全麻的风险及并发症以及支撑喉镜下的风险及并发症完全可以规避掉;e、复查简答,随访方便,患者随时有不适可以再行检查,遇到复发的患者可以直接进行二次手术等。
[Abstract]:Objective: to analyze the clinical features, early diagnosis and treatment of epiglottic cysts in adults and infants. To compare the advantages and disadvantages between traditional laryngoscopic excision of epiglottic cysts and outpatient electronic laryngoscope guided laser dissecting of epiglottic cysts. Methods: from February 2016 to January 2017, 20 cases of epiglottic cysts were collected. All patients were treated with minimally invasive semiconductor laser under local anesthesia. The clinical data were analyzed by SPSS 23.0.The average hospitalization days, the cost of treatment and the incidence of complications after operation were compared between the two groups. A survey of postoperative pain, postoperative recovery, postoperative recurrence and patient satisfaction was made. Results among 20 hospitalized patients, 12 were male and 8 were female, compared with traditional treatment and outpatient minimally invasive interventional therapy. The age was 25-65 years old. The minimum hospitalization days were 4 days, the maximum hospitalization days were 9 days, and the average hospitalization days were 6.4 days. 20 patients with minimally invasive interventional surgery in outpatient department were 10 males and 10 females. The age is 30-65 years old. All can leave 1 hour after operation. Inclusion criteria: all through electronic laryngoscope to determine the location, and have corresponding clinical symptoms. After statistical testing, It was found that there was no significant difference in the incidence of epiglottic cysts between men and women, but there was no statistical difference between the two in terms of postoperative recurrence. The outpatient patients undergoing minimally invasive interventional treatment with epigastric anesthesia were significantly shorter than those who were hospitalized for laryngoscopic surgery under general anesthesia. In terms of economic burden, the number of outpatient patients undergoing minimal invasive interventional treatment with surface anesthesia was significantly less than that under general anesthesia support laryngoscope. Greatly lighten the financial burden of patients. In terms of patient satisfaction, The average satisfaction of the outpatients undergoing minimal invasive interventional treatment with epigastric anesthesia was higher than that of the in-patients undergoing laryngoscopic surgery under general anesthesia. Conclusion: compared with the surgical treatment of epiglottic cysts under general anesthesia, The microinvasive interventional treatment of epiglottic cyst based on the principle of epiglottic cyst dissection by semiconductor laser under electronic laryngoscope under epiglottic anesthesia in outpatient clinic has the following advantages: (1) the cost is low, and the cost of medical treatment is greatly reduced. After greatly saving medical cost, developing simple, knowing the principle and using skillfully, most hospitals have the corresponding equipment to carry out this kind of treatment method, the patient has little pain, the patient satisfaction is high and the complication of operation is less. Compared with the operation under general anesthesia, the risks and complications of general anesthesia and the risks and complications of supporting laryngoscope can be avoided completely. The review is simple, the follow-up is convenient, the patients can be checked again if they feel uncomfortable at any time. The patient who meets the recurrence may carry on the second operation directly and so on.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R767.91

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