内镜辅助下动力切割技术治疗慢性扁桃体炎意义探讨

卢汉桂; 陈晓明; 曾宪平; 曹宸; 郭雪雪; 魏佳炜; 陈合新

doi:10.13418/j.issn.1001-165x.2018.01.024

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (1) : 105-107. DOI: 10.13418/j.issn.1001-165x.2018.01.024

临床研究

内镜辅助下动力切割技术治疗慢性扁桃体炎意义探讨

卢汉桂¹，　陈晓明²，　曾宪平³，　曹宸⁴，　郭雪雪⁴，　魏佳炜¹，　陈合新⁴

作者信息 +

Study on technique of performing tonsillectomy on chronic tonsillitis patients by endoscopic surgery

LU Han-gui¹, CHEN Xiao-ming², ZENG Xian-ping³, CAO Chen⁴, GUO Xue-xue⁴, WEI Jia-wei¹, CHEN He-xin⁴

Author information +

文章历史 +

摘要

目的　探讨经鼻内镜外科技术切割扁桃体的意义和手术技巧。方法　随机将64例慢性扁桃体炎患者分为电动切割组和剥离组，每组各32例。比较两组的术中出血量、术后手术时间、术后第7天白膜脱落情况及疼痛分数。结果　电动切割组较剥离组手术时间短、术中出血量少、术后疼痛分数显著性降低（P>0.05）；但白膜脱落情况及术后患者恢复正常饮食时间未见明显差异。结论　鼻内镜辅助下采用电外科技术进行扁桃体切除具有安全、快速、术后并发症少等明显优势，值得临床广泛推广。

Abstract

Objective　To investigate the meaning and the surgical techniques of performing tonsillectomy by endoscopic surgery.　Method　32 patients were treated by tonsillectomy (incising group) and 32 patients were treated by conventional stripping surgery (stripping group). The operation time, operation bleeding parameters, albuginea shedding as well as postoperative pain scale were compared and analyzed. Result　The incising group has much shorter operation time, milder postoperative pain and less blood loss (P<0.05). However, albuginea shedding and the time returning to normal diet did not significantly differ (P>0.05). Conclusion The tonsillectomy by endoscopic surgery is safer, faster with less postoperative complications than conventional stripping surgery, which is worth popularizing.

导出引用

卢汉桂,陈晓明,曾宪平,曹宸,郭雪雪,魏佳炜,陈合新. 内镜辅助下动力切割技术治疗慢性扁桃体炎意义探讨[J]. 中国临床解剖学杂志. 2018, 36(1): 105-107 https://doi.org/10.13418/j.issn.1001-165x.2018.01.024

LU Han-gui, CHEN Xiao-ming, ZENG Xian-ping, CAO Chen, GUO Xue-xue, WEI Jia-wei, CHEN He-xin. Study on technique of performing tonsillectomy on chronic tonsillitis patients by endoscopic surgery[J]. Chinese Journal of Clinical Anatomy. 2018, 36(1): 105-107 https://doi.org/10.13418/j.issn.1001-165x.2018.01.024

参考文献

[1] 周永，李雪，谢声权，等. 国内扁桃体切除术方法应用状况的调查[J]. 中国耳鼻咽喉颅底外科杂志, 2016, 22(6):476-479.
[2] 蒋振华，王杰，董钏，等. CO2激光扁桃体切除术的临床研究[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(3):119-121.
[3] 季慧，黄志纯，冯旭，等. 超声刀辅助扁桃体切除术与传统术式的对照研究[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(5):414-416.
[4] 钟贞，肖水芳，王春燕，等. 等离子扁桃体切除术与常规剥离法扁桃体切除术之比较[J]. 临床耳鼻咽喉头颈外科杂志, 2006, 20(9):391-392.
[5] 臧艳姿，马崧，万保罗，等. 低温等离子扁桃体切除术与传统术式的对照研究[J]. 中国眼耳鼻喉科杂志, 2015, 15(1):28-31.
[6] 刘大波，黄振云，赵东吉慧，等. 美国2011年版儿童扁桃体切除术临床实践指南介绍[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(11):966-968.
[7] Gallagher TQ, Wilcox L, Mcguire E, et al. Analyzing factors associated with major complications after adenotonsillectomy in 4776 patients: comparing three tonsillectomy techniques[J]. Otolaryngol Head Neck Surg, 2010,142(6): 886-892.
[8] Galindo TB, De Miguel GF, Whyte OJ. Tonsillectomy in adults: Analysis of indications and complications[J]. Auris Nasus Larynx, 2017,
[9] 磨宾宇，戴文斌，周永，等. 低功率单极电刀凝切术与低温等离子刀和传统剥离术对成人扁桃体切除术的效果对比分析[J]. 中国全科医学, 2012, 15(29): 3416-3418.
[10] 刘大波，谭宗瑜，钟建文，等. 儿童扁桃体腺样体低温等离子手术迟发性出血的初步研究[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(5):373-376.
[11]Brkic F, Mujic M, Umihanic S, et al. Haemorrhage Rates After Two Commonly Used Tonsillectomy Methods: a Multicenter Study[J]. Med Arch, 2017,71(2):119-121.
[12]Walker P, Gillies D. Post-tonsillectomy hemorrhage rates: are they technique-dependent?[J]. Otolaryngol Head Neck Surg,2007,136(4 Suppl):S27-S31.