本文選題：會(huì)厭囊腫　切入點(diǎn)：微創(chuàng)介入　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析會(huì)厭囊腫在成人和嬰幼兒的臨床特征、早期診斷及治療方案,比較傳統(tǒng)支撐喉鏡下會(huì)厭囊腫切除術(shù)與門診表麻下電子喉鏡引導(dǎo)下會(huì)厭囊腫的激光揭蓋術(shù)之間的優(yōu)勢(shì)與劣勢(shì),根據(jù)統(tǒng)計(jì)學(xué)結(jié)果,為后者的臨床推廣提供依據(jù)。方法:收集2016年2月~2017年1月就診于我科的會(huì)厭囊腫患者,其中住院患者20例,均采用支撐喉鏡下會(huì)厭囊腫摘除、電刀止血治療。門診患者20例,均應(yīng)用局麻下電子喉鏡下半導(dǎo)體激光微創(chuàng)介入微創(chuàng)治療。整理臨床數(shù)據(jù),應(yīng)用SPSS 23.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。比較二者在平均住院日、治療費(fèi)用、術(shù)中術(shù)后并發(fā)癥的發(fā)生情況、術(shù)后疼痛情況、術(shù)后恢復(fù)情況、術(shù)后復(fù)發(fā)情況以及患者滿意度調(diào)查。對(duì)比傳統(tǒng)治療方式與門診微創(chuàng)介入治療方式。結(jié)果:20例住院患者中,男性12例,女性8例,年齡在25-65歲之間。最少住院天數(shù)4天,最多住院天數(shù)9天,平均住院天數(shù)6.4天。20例門診微創(chuàng)介入手術(shù)患者,男性10例,女性10例,年齡在30-65歲之間。全部為術(shù)后觀察1小時(shí)即可離開。納入標(biāo)準(zhǔn):均經(jīng)過(guò)電子喉鏡明確位置,并有相應(yīng)的臨床癥狀。再經(jīng)過(guò)統(tǒng)計(jì)學(xué)方法檢驗(yàn),發(fā)現(xiàn)會(huì)厭囊腫的發(fā)病在男女比例上無(wú)統(tǒng)計(jì)學(xué)差異,在術(shù)后復(fù)發(fā)方面,二者沒有統(tǒng)計(jì)學(xué)差異。在平均住院日方面,門診表麻微創(chuàng)介入治療的患者大大短于住院全麻支持喉鏡下手術(shù)的患者。在平均出血量方面,門診表麻微創(chuàng)介入治療的患者大大少于住院全麻支持喉鏡下手術(shù)的患者。在患者經(jīng)濟(jì)負(fù)擔(dān)方面,門診表麻微創(chuàng)介入治療的患者明顯較住院全麻支持喉鏡下手術(shù)的患者少,大大減輕了患者的經(jīng)濟(jì)負(fù)擔(dān)。在患者滿意度上,門診表麻微創(chuàng)介入治療的患者的平均滿意程度較住院全麻支持喉鏡下手術(shù)的患者高。結(jié)論:相比于住院全麻下支撐喉鏡下會(huì)厭囊腫的手術(shù)治療,門診表麻下電子喉鏡下應(yīng)用半導(dǎo)體激光基于會(huì)厭囊腫揭蓋術(shù)原理對(duì)會(huì)厭囊腫進(jìn)行微創(chuàng)介入治療的方法具有如下優(yōu)勢(shì):a、費(fèi)用低廉,大大節(jié)約患者就醫(yī)費(fèi)用,大大節(jié)約醫(yī)療成本;b、開展簡(jiǎn)單,了解原理并能熟練運(yùn)用后,大多數(shù)醫(yī)院擁有相應(yīng)的設(shè)備便可以開展此種治療方法;c、患者痛苦小,就醫(yī)滿意度高;d、手術(shù)并發(fā)癥少,相對(duì)于全麻下支撐喉鏡下的手術(shù),對(duì)于全麻的風(fēng)險(xiǎn)及并發(fā)癥以及支撐喉鏡下的風(fēng)險(xiǎn)及并發(fā)癥完全可以規(guī)避掉;e、復(fù)查簡(jiǎn)答,隨訪方便,患者隨時(shí)有不適可以再行檢查,遇到復(fù)發(fā)的患者可以直接進(jìn)行二次手術(shù)等。
[Abstract]:Objective: to analyze the clinical features, early diagnosis and treatment of epiglottic cysts in adults and infants. To compare the advantages and disadvantages between traditional laryngoscopic excision of epiglottic cysts and outpatient electronic laryngoscope guided laser dissecting of epiglottic cysts. Methods: from February 2016 to January 2017, 20 cases of epiglottic cysts were collected. All patients were treated with minimally invasive semiconductor laser under local anesthesia. The clinical data were analyzed by SPSS 23.0.The average hospitalization days, the cost of treatment and the incidence of complications after operation were compared between the two groups. A survey of postoperative pain, postoperative recovery, postoperative recurrence and patient satisfaction was made. Results among 20 hospitalized patients, 12 were male and 8 were female, compared with traditional treatment and outpatient minimally invasive interventional therapy. The age was 25-65 years old. The minimum hospitalization days were 4 days, the maximum hospitalization days were 9 days, and the average hospitalization days were 6.4 days. 20 patients with minimally invasive interventional surgery in outpatient department were 10 males and 10 females. The age is 30-65 years old. All can leave 1 hour after operation. Inclusion criteria: all through electronic laryngoscope to determine the location, and have corresponding clinical symptoms. After statistical testing, It was found that there was no significant difference in the incidence of epiglottic cysts between men and women, but there was no statistical difference between the two in terms of postoperative recurrence. The outpatient patients undergoing minimally invasive interventional treatment with epigastric anesthesia were significantly shorter than those who were hospitalized for laryngoscopic surgery under general anesthesia. In terms of economic burden, the number of outpatient patients undergoing minimal invasive interventional treatment with surface anesthesia was significantly less than that under general anesthesia support laryngoscope. Greatly lighten the financial burden of patients. In terms of patient satisfaction, The average satisfaction of the outpatients undergoing minimal invasive interventional treatment with epigastric anesthesia was higher than that of the in-patients undergoing laryngoscopic surgery under general anesthesia. Conclusion: compared with the surgical treatment of epiglottic cysts under general anesthesia, The microinvasive interventional treatment of epiglottic cyst based on the principle of epiglottic cyst dissection by semiconductor laser under electronic laryngoscope under epiglottic anesthesia in outpatient clinic has the following advantages: (1) the cost is low, and the cost of medical treatment is greatly reduced. After greatly saving medical cost, developing simple, knowing the principle and using skillfully, most hospitals have the corresponding equipment to carry out this kind of treatment method, the patient has little pain, the patient satisfaction is high and the complication of operation is less. Compared with the operation under general anesthesia, the risks and complications of general anesthesia and the risks and complications of supporting laryngoscope can be avoided completely. The review is simple, the follow-up is convenient, the patients can be checked again if they feel uncomfortable at any time. The patient who meets the recurrence may carry on the second operation directly and so on.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R767.91

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