单极电刀不同模式切除儿童扁桃体的应用研究

发布时间：2018-05-21 20:13

本文选题：扁桃体切除术 + 手术方法　；参考：《广西医科大学》2012年硕士论文

【摘要】：目的：通过对单极电刀电凝模式与单极电刀切割模式切除儿童扁桃体的比较，探讨单极电刀两种不同模式切除儿童扁桃体的优缺点与合理性。方法：对20例需行双侧扁桃体切除术的患儿，以随机方法对其中一侧扁桃体采用单极电刀电切割法切除，另一侧采用单极电刀电凝切法切除。记录两种方法的出血量、手术时间、扁桃体窝创面肌纤维暴露率和损伤程度、术后咽痛程度、白膜生长情况及并发症等指标，并对以上指标进行比较分析。结果：20侧电凝切法全部顺利完成，20侧电切割法仅3侧（15%）能顺利完成；另17侧用电切割法开始后，在手术进程中由于频繁出血，无法继续，用电凝切法完成（下称混合法）。电凝切法的切除时间、止血时间、手术总时间、术中出血量分别为5.02±1.79min、1.30±1.23min、6.32±2.43min、2.63±2.59ml；电切割法的分别为11.17±3.26min、4.30±1.21min、15.47±4.10min、11.67±5.20ml；混合法的分别为9.18±2.51min、4.38±3.76min、13.37±4.39min、12.13±6.04ml。电凝切法与电切割法相比，以上对应指标的P值分别为0.00、0.01、0.00、0.01，两方法在上述所有指标的差异均有统计学意义，电凝切法优于电切割法；电凝切法与混合法相比，以上指标的P值均为0.00，电凝切法优于混合法；电切割法与混合法相比，以上指标的P值分别为0.50、0.31、0.54、0.60，两方法在上述所有指标的差异均无统计学意义。三法术中肌纤维暴露率之间没有差别；混合法的肌纤维损伤程度较电凝切法重，P=0.02。三法术后白膜生长情况相当，咽痛混合法明显。结论：由于手术过程中出血，运用单极电刀电切模式很难完成儿童扁桃体切除术。单极电刀电切模式法或混合法切除儿童扁桃体，两者的各项观察指标相当；与单极电刀电凝模式法相比，前两者在手术中的出血量、手术中各环节的耗时均多于电凝模式法，手术损伤等不良反应相当。在运用单极电刀进行儿童扁桃体切除术中，，低功率电凝模式是安全和高效的，是更为合理的模式。
[Abstract]:Objective: to explore the advantages and disadvantages and rationality of monopole electrocoagulation and monopole electrosurgical resection for tonsillectomy of children. Methods: twenty children with bilateral tonsillectomy were treated with monopole electrocution and unilateral electrocoagulation respectively. The bleeding volume, operation time, muscle fiber exposure rate and injury degree of tonsil fossa wound, postoperative pharynx pain, white membrane growth and complications were recorded and compared. Results all of the 20 side electrocoagulation and 20 side electrocution were successfully completed, and the other 17 sides were not able to continue because of frequent bleeding after the other 17 sides of electrocution (hereinafter referred to as the mixed method). The excision time, hemostasis time and total operation time of electrocoagulation were 5.02 卤1.79 min, 1.30 卤1.23 min, 6.32 卤2.43 min, 2.63 卤2.59 ml, 11.17 卤3.26 min, 4.30 卤1.21 min, 11.67 卤5.20 ml, 9.18 卤2.51min, 4.38 卤3.76min, 13.37 卤4.39min, 12.13 卤6.04ml, respectively. The P value of the above corresponding indexes is 0.000. 01 / 0. 01 respectively. The difference between the two methods in all the above indexes is statistically significant, and the electrocoagulation cutting method is superior to the electric cutting method, and the electric coagulation cutting method is better than the mixed method. The P value of the above indexes was 0.000.The electrocoagulation method was superior to the mixed method, and the P value of the above indexes was 0.50 ~ 0.31 ~ 0.54 ~ 0.60, respectively. There was no significant difference between the two methods in all the above indexes. There was no difference between the exposure rate of muscle fiber in the three spells, and the degree of muscle fiber injury in the mixed method was more serious than that in the electrocoagulation method (P0. 02). The growth of white membrane was the same after the three methods, and the pharynx pain mixed method was obvious. Conclusion: because of bleeding during operation, monopole electrosurgical resection is difficult to complete tonsillectomy in children. The monopole electrocution mode method or the mixed method for removing the tonsils of children had the same observation indexes, and compared with the monopole electrocoagulation mode method, the former two methods had more time consuming in the operation than the electric coagulation mode method in each part of the operation, and compared with the monopole electrocoagulation mode method, the former two methods took more time than the electrocoagulation mode method to remove the tonsils of children. Adverse reactions such as surgical injuries were comparable. In children tonsillectomy with monopole electric knife, low power electrocoagulation is safe, efficient and more reasonable.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R766.9

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