内镜下3种手术治疗成人腺样体肥大93例疗效比较  

Efficacy comparison of three kinds of endoscopic surgical treatments for 93 cases of adult adenoidal hypertrophy

作　　者：柳辉高 黄坚强 范震[2] 

机构地区：[1]宁波市镇海龙赛医院耳鼻咽喉科,浙江宁波315200 [2]杭州市第一人民医院消化内科,浙江杭州310006

出　　处：《中国现代医生》2015年第7期44-47,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2011RCB028)

摘　　要：目的观察比较3种微创手术下腺样体肥大患者的临床效果。方法随机筛选93例腺样体肥大确诊患者,分为低温等离子消融术组(A组,n=32)、微波热凝术组(B组,n=32)和激光术组(C组,n=29)。记录患者术中出血量、手术时间和黏膜损伤等情况,术后评价并发症(出血例数、残留数、鼻腔粘连、软腭水肿、感染、疼痛感VAS评分等)、恢复情况及总疗效和住院时间等。结果治愈率方面,A组显著高于其他两组(P<0.05),而总有效率方面,各组间无显著性差异(P>0.05)。A组在黏膜损伤、住院时间、鼻腔粘连及残留等方面也略优于B、C组,但在术中出血、手术时间和术后各种并发症上并无优势。结论应用经口鼻内镜下低温等离子消融术对腺样体肥大患者进行手术治疗的临床效果显著,相对安全且再手术概率较低,值得推广。Objective To observe and compare the clinical outcomes of three kinds of minimally invasive surgery on patients under adenoid hypertrophy. Methods All 93 cases of patients diagnosedas adenoidal hypertrophy were randomly selected and divided into three groups, low-temperature plasma ablation group（A, n=32）, microwave coagulation group（B, n=32） and laser surgery group（C, n=29）. Plenty of indicators were recorded, such as blood loss, operative time, mucosal injury, postoperative evaluation of complications（bleeding number of cases, the residual number of nasal adhesions, soft palate edema, infection, pain VAS score, etc.）, recovery, overall efficacy and hospitalization time.Results On the recovery rate, A group was significantly higher than others（P〈0.05）. On the total efficiency, each group was not significantly different（P〉0.05）. A group was also slightly better than B and C group on mucosal injury,hospitalization time, nasal adhesions and residues, but with no advantage on blood loss, operative time and postoperative complications. Conclusion Using transoral and nasal endoscopic low-temperature plasma ablation surgery to remedy patients with adenoid hypertrophy resulted into significant effect,relatively better safety, low probability of reoperation, and worthy of promotion.

关 键 词：微创手术 低温等离子消融术 微波热凝手术 激光术 腺样体肥大 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]