鼻内镜下低温等离子消融术和动力切割术治疗儿童腺样体肥大的对比研究  

Comparative study on the treatment of children adenoid hypertrophy by temperature controlled radio frequency and power cutting under nasal endoscopy

作　　者：王纯洁[1] 欧阳辉[2] 张健[1] WANG Chunjie OU Yanghui ZHANG Jian(Department of E.N.T, people＇s hospital Weiyuan county, Sichuan, 642450, Chin)

机构地区：[1]四川省威远县人民医院耳鼻咽喉科,四川内江642450 [2]四川省内江市第一人民医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2016年第6期439-442,411,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨儿童腺样体肥大（AH）在鼻内镜下应用低温等离子消融术（TCRF）与动力切割术治疗的临床效果。方法选取我院2012年6月~2015年6月收治的138例AH患儿,按随机数字表法等分为两组。在鼻内镜下,对照组采用动力切割术,观察组行TCRF。记录比较两组术中出血量与手术时间,手术前后阻塞性睡眠呼吸暂停-18量表（OSA-18）评分,术后6个月时临床疗效,术后并发症及随访1年期间复发情况。结果观察组术中出血量显著少于对照组（P〈0.01）,两组手术时间比较,差异无统计学意义（P〉0.05）;两组术后6个月时OSA-18评分与术前比较,均显著降低（P〈0.01）,但观察组OSA-18评分与对照组同期相比,差异无统计学意义（P〉0.05）;观察组总有效率为100.00%与对照组98.55%比较,差异无统计学意义（P〉0.05）;两组术后并发症发生率、随访复发率相比,差异也均无统计学意义（P〉0.05）。结论儿童AH在鼻内镜下应用TCRF治疗效果显著,且更有助于减少术中出血,降低手术对患儿机体的影响,同时在减少术后并发症和控制复发方面也略有优势,具有较高临床参考价值。Objective To investigate the clinical effect of temperature controlled radio frequency （TCRF） and power cutting on children adenoid hypertrophy （AH） under nasal endoscopy. Methods 138 cases of children with AH treated in our hospital from June 2012 June to June 2015 were selected and divided into two groups with the method of random number table. Under the nasal endoscope, the control group adopted power cutting, while the observation group was given TCRF. Then bleeding volume during the operation and operation time, obstruction sleep apnea-18 scale （OSA-18） score before and after the surgery, clinical efficacy after 6months, postoperative complications and recurrence in the follow-up 1 year of the two groups were recorded and compared. Results In the observation group, the amount of bleeding was significantly lower than that of the control group （P〈O.01）. But there was no significant difference in operation time between the two groups （P〉0.05）; in the two groups, the OSA-18 scores after 6 months of the operation were significantly lower than those before the operation （P〈0.01）, but the OSA-18 score of the observation group compared with the control group, the difference was not statistically significant （P〉0.05）; the total effective rate of observation group was 100.00%, and compared with 98.55% of the control group, the difference was not statistically significant （P〉0.05）; the incidence of postoperative complications and recurrence rate were compared between the two groups, and the difference was not statistically significant （P〉0.05）. Conclusion The application of TCRF in AH endoscopy has remarkable effect, and more helpful to reduce intraoperative bleeding and reduce the impact of surgery on the body of children, and also has a slightly advantage in reducing postoperative complications and recurrence, which has a higher clinical reference value.

关 键 词：鼻内镜 低温等离子消融术 动力切割术 儿童腺样体肥大 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]