發(fā)布時(shí)間：2018-01-19 15:28

  本文關(guān)鍵詞： 扁桃體 單極單刀 混切模式 剝離術(shù)　出處：《山東大學(xué)》2013年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的通過(guò)與傳統(tǒng)扁桃體剝離法相比較,研究高頻單極電刀混切模式在扁桃體切除術(shù)中的應(yīng)用效果。 方法自2012年06月至2013年03月山東大學(xué)第二醫(yī)院耳鼻喉科收治的因慢性扁桃體炎或扁桃體肥大引起的睡眠障礙性呼吸(sleeping disordered-breath ing, SDB)而入院待手術(shù)治療的患者中隨機(jī)抽取36例,男女不限,年齡4-40歲,根據(jù)隨機(jī)分組方法的原則,同一名患者一側(cè)扁桃體采用傳統(tǒng)剝離法切除,另一側(cè)扁桃體采用高頻單極電刀混切模式(以下簡(jiǎn)稱(chēng)電切電凝術(shù))切除,雙側(cè)均由同一術(shù)者(技術(shù)熟練、經(jīng)驗(yàn)豐富)完成。觀察并且記錄兩種手術(shù)方法的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后出血發(fā)生率、術(shù)后疼痛程度及持續(xù)時(shí)間、創(chuàng)面?zhèn)文ば纬汕闆r及術(shù)后偽膜脫落情況等指標(biāo)。對(duì)觀察指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果①電切電凝術(shù)組平均手術(shù)用時(shí)及術(shù)中出血量分別：8.18±2.33min.5.44±1.28ml,傳統(tǒng)剝離法組平均手術(shù)用時(shí)及術(shù)中出血量分別：16.98±2.84min.13.97±3.28ml, P=0.000,兩種手術(shù)方式切除扁桃體所用時(shí)間及術(shù)中出血量的差異在統(tǒng)計(jì)學(xué)上有意義,電切電凝術(shù)組手術(shù)用時(shí)僅為傳統(tǒng)剝離法的1/2,后者的出血量約為前者的2.5倍。同一手術(shù)方法(電切電凝術(shù)及傳統(tǒng)剝離術(shù))分別切除左、右側(cè)扁桃體所用時(shí)間及術(shù)中出血量的差異無(wú)統(tǒng)計(jì)學(xué)意義。 ②咽部疼痛程度及術(shù)后出血情況大致相當(dāng),但電切電凝側(cè)疼痛持續(xù)時(shí)間較長(zhǎng)(10.24±1.35d vs9.21±1.11d)。 ③所有病例術(shù)后雙側(cè)扁桃體窩偽膜皆生長(zhǎng)均勻良好,清潔無(wú)污穢,但電切電凝側(cè)偽膜生長(zhǎng)較對(duì)側(cè)厚且脫落延遲。 結(jié)論應(yīng)用高頻單極電刀混切模式切除扁桃體是安全、可行、易于操作的,大大減少了手術(shù)時(shí)間及術(shù)中出血量,提高了手術(shù)效率；不會(huì)加重術(shù)后疼痛程度及術(shù)后出血率；但有術(shù)后偽膜較厚、脫落延遲、疼痛持續(xù)時(shí)間較長(zhǎng)等缺點(diǎn)。
[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 鹵2.33 min and 5.44 鹵1.28 ml, respectively. The mean operative time and intraoperative blood loss in the traditional peeling group were: 16.98 鹵2.84 min. 13.97 鹵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 鹵1.35 vs9.21 鹵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.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R766.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 楊敬峰,李少龍;止血鉗在成人扁桃體剝離術(shù)中的應(yīng)用[J];安徽醫(yī)學(xué);2003年04期

2 張春林;李春雷;劉兆輝;林季珍;安偉;陳新野;;等離子扁桃體切除術(shù)與常規(guī)扁桃體剝離術(shù)術(shù)后出血的Meta分析[J];重慶醫(yī)學(xué);2012年15期

3 彭波;扁桃體切除術(shù)手術(shù)切口的改進(jìn)[J];廣東醫(yī)學(xué)院學(xué)報(bào);2003年06期

4 彭杰,陸靈娟;微波治療慢性扁桃體炎療效分析[J];廣西中醫(yī)學(xué)院學(xué)報(bào);2003年03期

5 劉鋒;李兆基;;微波在耳鼻喉科的應(yīng)用[J];國(guó)外醫(yī)學(xué).耳鼻咽喉科學(xué)分冊(cè);1993年04期

6 余文興;黃紅星;楊森;楊立;張靜;;低溫等離子用于兒童扁桃體消融術(shù)的臨床分析[J];中國(guó)醫(yī)藥科學(xué);2012年03期

7 楊心青,周水淼;半導(dǎo)體激光在耳鼻咽喉科的應(yīng)用[J];臨床耳鼻咽喉科雜志;2000年03期

8 程雷,時(shí)海波;扁桃體手術(shù)方法的新進(jìn)展[J];臨床耳鼻咽喉科雜志;2003年02期

9 許振躍;沈偉林;方銘達(dá);洪斌;李兆生;;單極電刀切除治療扁桃體病變122例臨床觀察[J];臨床耳鼻咽喉頭頸外科雜志;2009年20期

10 黃敏齊;張建國(guó);嚴(yán)小玲;劉綺明;黃映紅;;鼻內(nèi)窺鏡引導(dǎo)半導(dǎo)體激光下鼻甲部分切除術(shù)的臨床探討[J];山東大學(xué)耳鼻喉眼學(xué)報(bào);2005年06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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