本文選題：扁桃體切除術(shù) + 手術(shù)方法��； 參考：《廣西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：通過對(duì)單極電刀電凝模式與單極電刀切割模式切除兒童扁桃體的比較，探討單極電刀兩種不同模式切除兒童扁桃體的優(yōu)缺點(diǎn)與合理性。 方法：對(duì)20例需行雙側(cè)扁桃體切除術(shù)的患兒，以隨機(jī)方法對(duì)其中一側(cè)扁桃體采用單極電刀電切割法切除，另一側(cè)采用單極電刀電凝切法切除。記錄兩種方法的出血量、手術(shù)時(shí)間、扁桃體窩創(chuàng)面肌纖維暴露率和損傷程度、術(shù)后咽痛程度、白膜生長(zhǎng)情況及并發(fā)癥等指標(biāo)，并對(duì)以上指標(biāo)進(jìn)行比較分析。 結(jié)果：20側(cè)電凝切法全部順利完成，20側(cè)電切割法僅3側(cè)（15%）能順利完成；另17側(cè)用電切割法開始后，在手術(shù)進(jìn)程中由于頻繁出血，無法繼續(xù)，用電凝切法完成（下稱混合法）。電凝切法的切除時(shí)間、止血時(shí)間、手術(shù)總時(shí)間、術(shù)中出血量分別為5.02±1.79min、1.30±1.23min、6.32±2.43min、2.63±2.59ml；電切割法的分別為11.17±3.26min、4.30±1.21min、15.47±4.10min、11.67±5.20ml；混合法的分別為9.18±2.51min、4.38±3.76min、13.37±4.39min、12.13±6.04ml。電凝切法與電切割法相比，以上對(duì)應(yīng)指標(biāo)的P值分別為0.00、0.01、0.00、0.01，兩方法在上述所有指標(biāo)的差異均有統(tǒng)計(jì)學(xué)意義，電凝切法優(yōu)于電切割法；電凝切法與混合法相比，以上指標(biāo)的P值均為0.00，電凝切法優(yōu)于混合法；電切割法與混合法相比，以上指標(biāo)的P值分別為0.50、0.31、0.54、0.60，兩方法在上述所有指標(biāo)的差異均無統(tǒng)計(jì)學(xué)意義。三法術(shù)中肌纖維暴露率之間沒有差別；混合法的肌纖維損傷程度較電凝切法重，P=0.02。三法術(shù)后白膜生長(zhǎng)情況相當(dāng)，咽痛混合法明顯。 結(jié)論：由于手術(shù)過程中出血，運(yùn)用單極電刀電切模式很難完成兒童扁桃體切除術(shù)。單極電刀電切模式法或混合法切除兒童扁桃體，兩者的各項(xiàng)觀察指標(biāo)相當(dāng)；與單極電刀電凝模式法相比，前兩者在手術(shù)中的出血量、手術(shù)中各環(huán)節(jié)的耗時(shí)均多于電凝模式法，手術(shù)損傷等不良反應(yīng)相當(dāng)。在運(yùn)用單極電刀進(jìn)行兒童扁桃體切除術(shù)中，，低功率電凝模式是安全和高效的，是更為合理的模式。
[Abstract]:Objective: to explore the advantages and disadvantages and rationality of monopole electrocoagulation and monopole electrosurgical resection for tonsillectomy of children. Methods: twenty children with bilateral tonsillectomy were treated with monopole electrocution and unilateral electrocoagulation respectively. The bleeding volume, operation time, muscle fiber exposure rate and injury degree of tonsil fossa wound, postoperative pharynx pain, white membrane growth and complications were recorded and compared. Results all of the 20 side electrocoagulation and 20 side electrocution were successfully completed, and the other 17 sides were not able to continue because of frequent bleeding after the other 17 sides of electrocution (hereinafter referred to as the mixed method). The excision time, hemostasis time and total operation time of electrocoagulation were 5.02 鹵1.79 min, 1.30 鹵1.23 min, 6.32 鹵2.43 min, 2.63 鹵2.59 ml, 11.17 鹵3.26 min, 4.30 鹵1.21 min, 11.67 鹵5.20 ml, 9.18 鹵2.51min, 4.38 鹵3.76min, 13.37 鹵4.39min, 12.13 鹵6.04ml, respectively. The P value of the above corresponding indexes is 0.000. 01 / 0. 01 respectively. The difference between the two methods in all the above indexes is statistically significant, and the electrocoagulation cutting method is superior to the electric cutting method, and the electric coagulation cutting method is better than the mixed method. The P value of the above indexes was 0.000.The electrocoagulation method was superior to the mixed method, and the P value of the above indexes was 0.50 ~ 0.31 ~ 0.54 ~ 0.60, respectively. There was no significant difference between the two methods in all the above indexes. There was no difference between the exposure rate of muscle fiber in the three spells, and the degree of muscle fiber injury in the mixed method was more serious than that in the electrocoagulation method (P0. 02). The growth of white membrane was the same after the three methods, and the pharynx pain mixed method was obvious. Conclusion: because of bleeding during operation, monopole electrosurgical resection is difficult to complete tonsillectomy in children. The monopole electrocution mode method or the mixed method for removing the tonsils of children had the same observation indexes, and compared with the monopole electrocoagulation mode method, the former two methods had more time consuming in the operation than the electric coagulation mode method in each part of the operation, and compared with the monopole electrocoagulation mode method, the former two methods took more time than the electrocoagulation mode method to remove the tonsils of children. Adverse reactions such as surgical injuries were comparable. In children tonsillectomy with monopole electric knife, low power electrocoagulation is safe, efficient and more reasonable.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R766.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉健萍;賀帥;;高頻電刀在手術(shù)中引起的意外傷害與預(yù)防措施[J];包頭醫(yī)學(xué)院學(xué)報(bào);2009年04期

2 易紅;手術(shù)中高頻電刀安全問題的探討[J];華夏醫(yī)學(xué);2004年02期

3 葉飛;傅敏儀;黃桂球;;全麻單極電刀切除扁桃體良性病變86例的療效觀察[J];檢驗(yàn)醫(yī)學(xué)與臨床;2011年07期

4 隋天恩;高頻電刀原理及燙傷預(yù)防[J];青海醫(yī)學(xué)院學(xué)報(bào);1998年04期

5 周培萱;高頻電刀致皮膚燒傷的原因分析及預(yù)防[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2003年21期

6 趙衛(wèi)全;高頻電刀的基本原理及使用[J];醫(yī)療設(shè)備信息;2001年01期

7 李精祥;;高頻電刀的灼傷與防護(hù)[J];醫(yī)療裝備;1993年01期

8 孫紅華;高頻電刀的灼傷及預(yù)防[J];醫(yī)療裝備;2002年05期

9 趙慶儒;;全麻、表麻下兒童扁桃體切除術(shù)的臨床觀察[J];中國(guó)醫(yī)藥指南;2010年02期

10 孫越峰;周媛媛;;兒童單極電刀扁桃體切除術(shù)的臨床應(yīng)用[J];中華耳鼻咽喉頭頸外科雜志;2006年01期

相關(guān)碩士學(xué)位論文 前1條

1 梁瑜珊;單極電刀電凝模式切除兒童扁桃體的臨床研究[D];廣西醫(yī)科大學(xué);2010年

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