腺样体切除术后疗效不佳原因分析

发布时间：2018-01-19 11:05

本文关键词： 腺样体肥大腺样体切除术疗效不佳　出处：《大连医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的：探讨腺样体肥大切除术后疗效不佳的临床原因,以便进一步提高疗效。方法：随机选取30例我科腺样体切除病例,均在全麻鼻内镜下行腺样体切除术,同时行术前术后相关治疗,随访3月—1年。腺样体肥大患儿认知能力伟氏测试。结果：1例患儿腺样体切除术后出血,3例合并鼻中隔偏曲过敏性鼻炎的患者鼻塞缓解欠佳,1例合并扁桃体肥大的患者未行扁桃体手术睡眠打鼾缓解不佳,之后行扁桃体切除后症状消退。1例肥胖鼾症患者腺样体双扁桃体切除术后效果不佳。合并分泌性中耳炎术后通过鼻部滴药及鼓膜穿刺听力恢复正常。结论：腺样体肥大合并扁桃体肥大,应该同期行扁桃体切除,合并分泌性中耳炎的最好同期行鼓膜置管术或鼓膜穿刺术,合并儿童鼻窦炎的围手术期抗炎鼻腔滴药及口服吉诺通药物,鼻中隔偏曲及下颌畸形患儿疗效欠佳,需要进一步矫正鼻中隔及下颌畸形,肥胖患儿术后必须减肥治疗。腺样体切除术注意手术适应症选择,术中精细操作,围手术期治疗及合并相关疾病后续治疗较为重要。
[Abstract]:Objective: to investigate the clinical causes of poor curative effect after adenoidectomy in order to improve the curative effect. Methods: 30 cases of adenoidectomy in our department were randomly selected. All patients were treated with adenoidectomy under general anesthesia and nasal endoscope. The follow-up was March to 1 year. The cognitive ability of children with adenoid hypertrophy was measured by VW. Results one child with hemorrhage after adenoidectomy and 3 patients with nasal septum deviation and allergic rhinitis had poor nasal obstruction and remission. One patient with tonsil hypertrophy did not perform tonsillectomy to relieve sleep snoring. After tonsillectomy, the symptoms of 1 cases of obesity snoring patients after tonsillectomy after adenoid double tonsillectomy effect is not good, combined with secretory otitis media by nasal drops and tympanic membrane puncture hearing recovery to normal. Conclusion: adenoid hypertrophy combined with tonsillar hypertrophy should be performed at the same time tonsillectomy combined with secretory otitis media the best at the same time the tympanic membrane tube or tympanic membrane puncture. Children with sinusitis complicated with perioperative anti-inflammatory nasal drip and oral Ginotone, nasal septum deviation and mandibular malformation of children with poor curative effect, need to further correction of nasal septum and mandibular malformation. It is important for children with obesity to lose weight after surgery. It is important for adenoidectomy to pay attention to the choice of operation indication, fine operation, perioperative treatment and follow-up treatment of associated diseases.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

【参考文献】