儿童扁桃体挤切与低温等离子手术效果的比较研究
摘要
目的比较挤切与低温等离子两种手术方法切除儿童扁桃体术后疼痛、术后口腔异味及创面恢复情况。方法选择单纯因扁桃体肥大引起小儿阻塞性睡眠呼吸暂停综合征(OSAHS)的患者总计97例。挤切术切除双侧扁桃体的患者49例为观察组,低温等离子切除双侧扁桃体的患者48例为对照组。比较术后疼痛、扁桃体术后被膜厚度、扁桃体窝伪膜脱落时间及术后口腔异味对比两组术式的相关差别。结果观察组较对照组术后疼痛轻,第1日VAS评分无统计学差异(P>0.05),术后3、7、15、30天有显著的统计学差异(P<0.01);观察组较对照组术后扁桃体窝伪膜脱落时间更(P<0.05);观察组术后口腔异味发生率较对照组低且异味程度轻。结论挤切方法较低温等离子手术切除扁桃体术后咽部疼痛及口腔异味轻,术后伪膜脱落时间短,创面恢复更快,因此挤切法在儿童扁桃体手术中具有更明显的优势。
引文
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[7]MAGDALENAM L,SOLE A,BLANCO V,e t al.Histological analysis of tonsillectomies:relationship with surgical technique,post-operative pain and haemorrhage[J]J Laryngol Otol,2016,130(12):1142-1146.
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[12]MODI K,MONFORTE H,GELLER K A,et al.Histologic assessment of the rmalinjury to tonsillectom specimens:a comparison of electrocautery,coblation harmonic scalpel,and tonsillotome[J].Laryngoscope2009,119(11):2248-2251.
[13]ROJE Z,RACIC G,DOGAS Z.Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children:aprospective randomized single-blind study[J]Coll Antropol,2009,33(1):293-298.
[14]马俊.含漱清热凉血方对慢性扁桃体炎低温等离子术后炎症反应的临床研究[D].南京中医药大学,2018.
[15]ItziarAlvarez Palacios(2017)Postoperative Pain in Adult Tonsillectomy:Is There AnyDifference Between the Technique Indian J Otolaryngol Head Neck Surg 117:1058-1059.
[16]李莹,赵宏辉,张虹.低温等离子融切术与扁桃体剥离术临床应用比较[J].分子影像学2017,32(3):55-56.
[2]HUANG X Z,WANG J B,KONG W J.Practice of otorhinolaryn gology-head and neck surgery[M].2th ed,Beijing:People’s Medical Publishing House,2007:377-387
[3]Brigger M T,Cunningham M J,Hartnick C J.Dexam ethasone administration and postoperative bleeding risk in children undergoing tonsillectomy[J].Arch Otolaryngol Head Neck Surg,2010,136(8):766-772.
[4]Ozkiris M,Kapusuz Z,Saydam L.Comparison of threetechniques in adult tonsillectomy[J].Eur Arch Otorhino laryngol,2013,270(3):1143-1147.
[5]祝江才,金斌,林晓,等.电凝法扁桃体切除术180例[J].山东大学耳鼻喉眼学报,2010,24(2):57-59.ZHUJiangcai,JIN Bin,LIN Xiao,et al.Electro-coagu lation tonsillectomy(a report of 180 cases)[J].J Otolar yngol Ophthalmol Shandong Univ,2010,24(2):57-59.
[6]Khalid Al Sebeihb,Jumana Hussain.Postoperative complications following tonsil and adenoid removal in Kuwaiti children:Annals of Medicine and Surgery[J].2018,33:124-128.
[7]MAGDALENAM L,SOLE A,BLANCO V,e t al.Histological analysis of tonsillectomies:relationship with surgical technique,post-operative pain and haemorrhage[J]J Laryngol Otol,2016,130(12):1142-1146.
[8]BURTON M J,DOREE C.Coblation versus other surguical techniques for tonsillectomy[J].Cochrane Database Syst Rev,2007,3:CD004619.
[9]JONES D T,KENNA M A,GUDI J,et al.Comparison of postoperative pain in pediatric patients undergoing coblation tonsillectomy versus cautery tonsillectomy[J]Otolaryngol Head Neck Surg,2011,144:972-977.
[10]黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2016.375-377.
[11]熊景鹏.低温等离子扁桃体消融术临床分析[J].中国耳鼻咽喉头颈外科,2011;18(3):164-165.
[12]MODI K,MONFORTE H,GELLER K A,et al.Histologic assessment of the rmalinjury to tonsillectom specimens:a comparison of electrocautery,coblation harmonic scalpel,and tonsillotome[J].Laryngoscope2009,119(11):2248-2251.
[13]ROJE Z,RACIC G,DOGAS Z.Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children:aprospective randomized single-blind study[J]Coll Antropol,2009,33(1):293-298.
[14]马俊.含漱清热凉血方对慢性扁桃体炎低温等离子术后炎症反应的临床研究[D].南京中医药大学,2018.
[15]ItziarAlvarez Palacios(2017)Postoperative Pain in Adult Tonsillectomy:Is There AnyDifference Between the Technique Indian J Otolaryngol Head Neck Surg 117:1058-1059.
[16]李莹,赵宏辉,张虹.低温等离子融切术与扁桃体剥离术临床应用比较[J].分子影像学2017,32(3):55-56.