鼻内镜辅助低温等离子腺样体切除术的临床疗效观察  

Clinical efficacy of nasal endoscope-assisted low temperature plasma adenoidectomy

作　　者：郭建东 尤慧华[1] 李栋[1] 张玉兰[1] 方勇进 

机构地区：[1]浙江省金华市中心医院耳鼻咽喉-头颈外科,浙江金华321000

出　　处：《中国内镜杂志》2017年第9期64-68,共5页China Journal of Endoscopy

摘　　要：目的评估鼻内镜辅助低温等离子腺样体切除术的临床疗效。方法该研究共纳入2012年5月-2016年8月因腺样体肥大在该院行腺样体切除术的患儿100例,将其随机分为观察组(50例)和对照组(50例),观察组患儿行鼻内镜辅助腺样体低温等离子消融术,对照组患儿行鼻内镜辅助腺样体电动切割术。分析和比较两组的手术时间、出血量、鼻腔恢复通气时间、临床疗效和术后并发症等。结果观察组的手术时间为(4.9±1.6)min、出血量为(19.6±5.6)ml、鼻腔恢复通气时间为(2.9±0.5)d,均明显少于对照组的(11.9±3.9)min、(61.6±12.1)ml和(5.9±1.6)d,两组间差异均有统计学意义(P<0.05)。观察组的临床疗效为92.0%,与对照组86.0%相比,两组间差异无统计学意义(P>0.05)。观察组中,疼痛指数为(1.8±1.0)分,明显低于对照组(5.6±2.1)分,两组间差异具有统计学意义(P<0.05),而两组患儿在术后出血、发热和鼾声方面差异均无统计学意义(均P>0.05)。另外,观察组中,无患儿出现并发症,对照组并发症发生率为10.0%,两组间差异具有统计学意义(P<0.05)。结论鼻内镜辅助低温等离子消融术治疗腺样体肥大的临床疗效显著,疼痛小,并发症少,可作为治疗小儿腺样体肥大的常规临床术式。Objective To evaluate the clinical efficacy of nasal endoscope-assisted low temperature plasma adenoidectomy. Methods 100 patients who underwent adenoidectomy from May 2012 to August 2016 were enrolled in the study. All the patients were randomly divided into the observation group （50 cases） and control group （50 cases）. Patients in the observation group underwent nasal endoscope-assisted low-temperature plasma adenoidectomy, and patients in control group was treated with nasal endoscope-assisted electric adenoidectomy. The operation time, bleeding volume, recovery time of nasal ventilation, clinical efficacy, postoperative complications of the two groups were analyzed and compared. Results In the observation group, the operation time, bleeding volume, recovery time of nasal ventilation was （4.9 ± 1.6） min, （19.6 ±5.6） ml and （2.9 ±0.5） d, respectively, which was significantly less than that of the control group （1 1.9 ± 3.9） min, （61.6 ± 12.1） ml and （5.9 ±1.6） d, respectively （P 〈 0.05）. The clinical efficacy of the observation group and the control group was 92.0%, and 86.0%, there was no significant difference between the two groups （P 〉 0.05）. In the observation group, the pain index was （1.8 ± 1.0）, which was significantly lower than that of the control group （5.6 ±2.1）, the difference was statistically significant （P 〈 0.05）, and there was no significant difference with respect to postoperative hemorrhage, fever and snoring （P 〉 0.05）. In addition, there was no postoperative complication observed in the observation group, while, the complication rate of the control group was 10.0%, the difference between the two groups was statistically significant （P 〈 0.05）. Conclusion Nasal endoscope-assisted low temperature plasma adenoidectomy is effective and safe in the treatment of adenoid hypertrophy with less pain and fewer complications, which can be used as a routine clinical treatment for adenoid hypertrophy in children.

关 键 词：腺样体肥大 鼻内镜 低温等离子消融术 临床疗效 

分 类 号：R766.4[医药卫生—耳鼻咽喉科]