单极电刀电凝模式切除儿童扁桃体的临床研究

发布时间：2018-04-30 06:25

本文选题：扁桃体切除术 + 手术方法　；参考：《中国耳鼻咽喉颅底外科杂志》2012年06期

【摘要】：目的通过与传统剥离法扁桃体切除术比较,探讨单极电刀电凝模式(以下称凝切法)切除儿童扁桃体的临床意义。方法对30例需行双侧扁桃体切除术的儿童患者,采用同体异侧对比的方法,按照随机方案一侧扁桃体采用凝切法切除、另一侧采用剥离法切除;分别记录双侧扁桃体的切除时间、止血时间、总手术时间、术中出血量,并观察术中创面损伤、术后白膜生长、咽痛反应等,并对两组数据进行统计分析。结果凝切法与剥离法的切除时间分别为(6.5±2.6)min和(5.6±2.7)min,两种手术方法切除扁桃体的时间差异无统计学意义(P=0.14)。凝切法的止血时间、总手术时间、术中出血量分别为(2.5±2.8)min、(9.0±4.3)min、(6.0±6.8)ml,剥离法的分别为(7.7±3.9)min、(13.2±5.6)min、(18.9±8.8)ml,两种方法在止血时间、总手术时间、术中出血量方面的差异均有统计学意义(P=0.00),凝切法治疗儿童扁桃体肥大疗效明显优于剥离法。凝切法侧的肌纤维损伤积分优于剥离法,其差异具有统计学意义(Z=-4.916,P=0.00)。术后两组白膜生长情况和咽痛比较无明显差异。结论与传统的扁桃体剥离法相比,凝切法的术野清晰、手术时间短、术中出血量少、手术对组织的损伤轻。单极电刀电凝模式儿童扁桃体切除术安全、高效,值得临床推广使用。
[Abstract]:Objective to explore the clinical significance of monopole electrocoagulation in the removal of tonsillectomy in children by comparing with traditional tonsillectomy. Methods Thirty children who needed bilateral tonsillectomy were treated by congealing and dissecting according to the random scheme. The time of bilateral tonsillectomy, hemostasis time, total operative time, intraoperative bleeding volume, wound injury during operation, white membrane growth after operation, pharynx pain reaction were recorded, and the data of the two groups were statistically analyzed. Results the excision time was 6.5 卤2.6)min and 5.6 卤2.7 minutes, respectively. There was no significant difference in the time of tonsillectomy between the two methods. The hemostasis time, the total operative time and the intraoperative bleeding volume of the coagulation method were 2.5 卤2.8 min, 9.0 卤4.3 min, 6.0 卤6.8 ml, and 7.7 卤3.9 min, 13.2 卤5.6 min, 18.9 卤8.8 ml, respectively. The total operative time and hemostasis time of the two methods were 18.9 卤8.8 ml. The difference of intraoperative bleeding volume was statistically significant. The effect of coagulation was better than that of peeling method in the treatment of tonsil hypertrophy in children. The score of muscle fiber injury in the side of the coagulation-cutting method was better than that in the peeling method, and the difference was statistically significant. There was no significant difference in white membrane growth and pharyngeal pain between the two groups after operation. Conclusion compared with the traditional tonsillectomy, the surgical field of coagulation is clear, the operation time is short, the amount of intraoperative bleeding is less, and the tissue injury is less. Monopole electrocoagulation is safe and effective for tonsillectomy in children.
【作者单位】：广西医科大学第一附属医院耳鼻咽喉科;
【基金】：广西壮族自治区卫生厅资助项目(Z2012064)
【分类号】：R766.18

【共引文献】