高频单极电刀混切模式在扁桃体切除术中的应用效果

发布时间：2018-01-19 15:28

本文关键词： 扁桃体单极单刀混切模式剥离术　出处：《山东大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的通过与传统扁桃体剥离法相比较,研究高频单极电刀混切模式在扁桃体切除术中的应用效果。方法自2012年06月至2013年03月山东大学第二医院耳鼻喉科收治的因慢性扁桃体炎或扁桃体肥大引起的睡眠障碍性呼吸(sleeping disordered-breath ing, SDB)而入院待手术治疗的患者中随机抽取36例,男女不限,年龄4-40岁,根据随机分组方法的原则,同一名患者一侧扁桃体采用传统剥离法切除,另一侧扁桃体采用高频单极电刀混切模式(以下简称电切电凝术)切除,双侧均由同一术者(技术熟练、经验丰富)完成。观察并且记录两种手术方法的手术时间、术中出血量、术后出血发生率、术后疼痛程度及持续时间、创面伪膜形成情况及术后伪膜脱落情况等指标。对观察指标进行统计学分析。结果①电切电凝术组平均手术用时及术中出血量分别：8.18±2.33min.5.44±1.28ml,传统剥离法组平均手术用时及术中出血量分别：16.98±2.84min.13.97±3.28ml, P=0.000,两种手术方式切除扁桃体所用时间及术中出血量的差异在统计学上有意义,电切电凝术组手术用时仅为传统剥离法的1/2,后者的出血量约为前者的2.5倍。同一手术方法(电切电凝术及传统剥离术)分别切除左、右侧扁桃体所用时间及术中出血量的差异无统计学意义。 ②咽部疼痛程度及术后出血情况大致相当,但电切电凝侧疼痛持续时间较长(10.24±1.35d vs9.21±1.11d)。 ③所有病例术后双侧扁桃体窝伪膜皆生长均匀良好,清洁无污秽,但电切电凝侧伪膜生长较对侧厚且脱落延迟。结论应用高频单极电刀混切模式切除扁桃体是安全、可行、易于操作的,大大减少了手术时间及术中出血量,提高了手术效率；不会加重术后疼痛程度及术后出血率；但有术后伪膜较厚、脱落延迟、疼痛持续时间较长等缺点。
[Abstract]:Objective to study the effect of high frequency monopole electric knife in tonsillectomy by comparing with traditional tonsillectomy. Methods from June 2012 to March 2013, sleep disorders caused by chronic tonsillitis or tonsillar hypertrophy were treated in the Department of Otorhinolaryngology, second Hospital of Shandong University. Sleeping disordered-breath ing. SDBs were randomly selected from 36 patients, male and female, aged 4-40 years. According to the principle of randomized grouping, the tonsil of one side of the same patient was removed by traditional stripping method. The tonsil on the other side was removed by high frequency monopole electrocoagulation (hereinafter referred to as electrocoagulation) and both sides were treated by the same operation (skilled in technique). To observe and record the operation time, the amount of blood loss, the incidence of postoperative bleeding, the degree of postoperative pain and duration of the two methods. The formation of pseudomembrane and the loss of pseudomembrane after operation were analyzed statistically. Results (1) the average operative time and blood loss in the electrocoagulation group were 8.18 卤2.33 min and 5.44 卤1.28 ml, respectively. The mean operative time and intraoperative blood loss in the traditional peeling group were: 16.98 卤2.84 min. 13.97 卤3.28 ml, P 0.000, respectively. There was significant difference in the time and amount of blood loss between the two methods of tonsillectomy. The operative time of electrocoagulation group was only 1/2 of that of the traditional exfoliation method. The amount of bleeding in the latter was about 2.5 times of that in the former. There was no significant difference in the time and amount of intraoperative bleeding between the left and right tonsils in the same operation (electrocoagulation and traditional dissection). 2the degree of pharyngeal pain and postoperative bleeding were about the same, but the duration of electrocoagulation side pain was 10.24 卤1.35 vs9.21 卤1.11 d. 3 all the pseudomembrances of bilateral tonsil fossa grew homogeneously and clean without contamination after operation, but the growth of pseudomembranous membrane in the electrocoagulation side was thicker than that in the contralateral side and the abscission was delayed. Conclusion it is safe, feasible and easy to operate by using high frequency monopole electric knife to remove tonsil, which can greatly reduce the operation time and blood loss during operation, and improve the efficiency of operation. The degree of postoperative pain and the rate of postoperative bleeding will not be aggravated; However, there are some shortcomings such as thicker pseudomembrances, delayed shedding and long duration of pain.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R766.9

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