扁桃体等离子切除手术入路探讨  

Discussion on surgical approach of coblation tonsillectomy

作　　者：陈洽鑫[1] 刘漪[1] 周佳亮[1] 麦飞[1] 张心丽[1] 

机构地区：[1]广东省妇幼保健院耳鼻咽喉科,广东广州511400

出　　处：《中国当代医药》2017年第17期95-98,共4页China Modern Medicine

摘　　要：目的探讨扁桃体等离子切除的最佳手术入路。方法回顾性分析我院2014年8月~2015年7月行扁桃体等离子切除术患儿的资料和手术情况,根据扁桃体的形态和位置分为包埋型、粘连性、普通型,评估不同手术入路在不同类型扁桃体切除中的情况,评估指标为扁桃体切除时黏附软组织范围的评分和术后的疼痛评分。结果咽腭入路在普通型和包埋型扁桃体中的切除软组织评分高于舌腭入路,差异有统计学意义(P<0.05)。两种手术方式在粘连型扁桃体中的切除软组织评分比较,差异无统计学意义(P>0.05)。咽腭入路在普通型、包埋型扁桃体中的术后第1、2、3天疼痛程度低分高于舌腭入路,差异有统计学意义(P<0.05)。两种手术方式在粘连型扁桃体中的术后第1、2、3天疼痛程度评分比较,差异无统计学意义(P>0.05)。结论咽腭入路的扁桃体低温等离子切除手术具有一定优势,尤其对于包埋型扁桃体,提倡常规使用咽腭入路,该入路术中创伤小、术后疼痛反应少,值得推广。Objective To explore the optimal surgical approach of coblation tonsillectomy.Methods The data and operation of children patients undergone coblation tonsillectomy from August 2014 to July 2015 were retrospectively analyzed.According to the morphology and location of tonsils,all patients were divided into embedding,adhesive,and common types.The different surgical approaches in varied types of tonsillectomy were evaluated.The evaluated indexes were score of adhesive soft tissue range on tonsillectomy and score of postoperative pain.Results The score of removing soft tissue via velopharyngeal approach in the common and embedded type of tonsils was higher than that via pharynx-palate approach,with significant difference（P〈0.05）.There were no significant differences in the scores of removing soft tissue between the two operation methods in the adhesive type of tonsil（P〉0.05）.The score of pain via pharynx-palate approach in the common and embedded adhesive type of tonsils at the first,second,third days after the operation was lower than that via pharynx-palate approach,with significant difference（P〈0.05）.There were no significant differences in the score of pain at the first,second,third days after the operation between the two operation methods in the adhesive type of tonsil（P〉0.05）.Conclusion Coblation tonsillectomy via pharynx-palate approach has some advantages including small trauma and few postoperative pain reactions,especially for embedding-type tonsil,which is worthy of promotion.

关 键 词：低温等离子刀 扁桃体切除 手术技巧 儿童 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]