本文選題：扁桃體切除術(shù) + 手術(shù)方法�。� 參考：《中國(guó)耳鼻咽喉顱底外科雜志》2012年06期

【摘要】：目的通過(guò)與傳統(tǒng)剝離法扁桃體切除術(shù)比較,探討單極電刀電凝模式(以下稱凝切法)切除兒童扁桃體的臨床意義。方法對(duì)30例需行雙側(cè)扁桃體切除術(shù)的兒童患者,采用同體異側(cè)對(duì)比的方法,按照隨機(jī)方案一側(cè)扁桃體采用凝切法切除、另一側(cè)采用剝離法切除;分別記錄雙側(cè)扁桃體的切除時(shí)間、止血時(shí)間、總手術(shù)時(shí)間、術(shù)中出血量,并觀察術(shù)中創(chuàng)面損傷、術(shù)后白膜生長(zhǎng)、咽痛反應(yīng)等,并對(duì)兩組數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果凝切法與剝離法的切除時(shí)間分別為(6.5±2.6)min和(5.6±2.7)min,兩種手術(shù)方法切除扁桃體的時(shí)間差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.14)。凝切法的止血時(shí)間、總手術(shù)時(shí)間、術(shù)中出血量分別為(2.5±2.8)min、(9.0±4.3)min、(6.0±6.8)ml,剝離法的分別為(7.7±3.9)min、(13.2±5.6)min、(18.9±8.8)ml,兩種方法在止血時(shí)間、總手術(shù)時(shí)間、術(shù)中出血量方面的差異均有統(tǒng)計(jì)學(xué)意義(P=0.00),凝切法治療兒童扁桃體肥大療效明顯優(yōu)于剝離法。凝切法側(cè)的肌纖維損傷積分優(yōu)于剝離法,其差異具有統(tǒng)計(jì)學(xué)意義(Z=-4.916,P=0.00)。術(shù)后兩組白膜生長(zhǎng)情況和咽痛比較無(wú)明顯差異。結(jié)論與傳統(tǒng)的扁桃體剝離法相比,凝切法的術(shù)野清晰、手術(shù)時(shí)間短、術(shù)中出血量少、手術(shù)對(duì)組織的損傷輕。單極電刀電凝模式兒童扁桃體切除術(shù)安全、高效,值得臨床推廣使用。
[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 鹵2.6)min and 5.6 鹵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 鹵2.8 min, 9.0 鹵4.3 min, 6.0 鹵6.8 ml, and 7.7 鹵3.9 min, 13.2 鹵5.6 min, 18.9 鹵8.8 ml, respectively. The total operative time and hemostasis time of the two methods were 18.9 鹵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.
【作者單位】： 廣西醫(yī)科大學(xué)第一附屬醫(yī)院耳鼻咽喉科;
【基金】：廣西壯族自治區(qū)衛(wèi)生廳資助項(xiàng)目(Z2012064)
【分類(lèi)號(hào)】：R766.18

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