鼻内镜下腺样体低温等离子消融术与切割术的短期疗效比较及对咽鼓管功能的影响  

Comparison of short-term efficacy of endoscopic adenoid hypothermic plasma ablation and cleavage and its effect on Eustachian tube function

作　　者：张国顺[1] 黄晓阳[1] 李守民[1] 

机构地区：[1]河南省安阳地区医院耳鼻咽喉头颈外科,河南安阳455000

出　　处：《中国耳鼻咽喉头颈外科》2017年第4期194-197,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的鼻内镜下腺样体低温等离子消融术的短期疗效及对咽鼓管功能的影响。方法选取我院2013年3月~2015年3月收治的儿童阻塞性睡眠呼吸暂停低通气综合征患者75例,按照手术方式不同分为行鼻动力切割组(30例)和低温等离子消融组(45例),比较两组患者手术时间、术中出血量以及随访6个月后的临床疗效以及咽鼓管功能情况。结果低温等离子消融组腺样体切除时间、手术时间、术中出血量均明显优于鼻动力切割组,比较差异具有统计学意义(P<0.05);低温等离子消融组并发症的发生情况明显高于鼻动力切割组,比较差异具有显著性(P<0.05);两组患者临床总有效率以及患者术后疾病特异性生活质量调查表(OSA-18)评分相当,治疗后患者的生活质量评分均有明显改善,组间比较没有显著差异(P>0.05)。结论低温等离子消融术和鼻动力切割术两种方法的临床疗效相当,低温等离子消融术术中出血量明显少于鼻动力切割术,这种手术方式微创且安全,但是其术后继发感染和继发出血量较高,应需要进一步的研究。OBJECTIVE The short-term efficacy of endoscopic adenoid hypothermic plasma ablation and its effect on Eustachian tube function. METHODS 75 patients with obstructive sleep apnea hypopnea syndrome who were treated in our hospital from March 2013 to March 2015 were divided into two groups according to the different operative methods： nasal power cutting group（30 cases） and low temperature plasma ablation group（45 cases）, comparison of the two groups of patients with surgery time, intraoperative blood loss and follow-up after 6 months of clinical efficacy and Eustachian tube function. RESULTS The time of resection, operation time and intraoperative blood loss were significantly better in the low-temperature plasma ablation group than that in the rhineetomy group, the difference was statistically significant（P〈0.05）; The incidence of complications in the low-temperature plasma ablation group was significantly higher than that in the rhinectomy group, and the difference was significant（P〈0.05）; there was no significant difference between the two groups in the total effective rate and the postoperative disease-specific quality of life questionnaire（OSA-18） and there was no significant difference in the quality of life between the two groups（P〉0.05）. CONCLUSION The clinical efficacy of low-temperature plasma ablation is close to nasal dynamic cutting, but low-temperature plasma ablation surgery in the amount of bleeding was significantly less than the nasal excision, this surgical approach is minimally invasive and safe, but its postoperative secondary infection and secondary bleeding is high, so this need for further study.

关 键 词：内窥镜检查 咽鼓管 治疗结果 射频消融术 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]