超声刀扁桃体切除术与低温等离子扁桃体切除术的对比研究  

A comparative analysis of harmonic scalpel tonsillectomy and coblation tonsillectomy

作　　者：张杰[1] 陈雪梅[1] 许安廷[1] ZHANG Jie C-HEN Xuemei XU Anting(Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Shandong University, Jinan 250033, Shandong, Chin)

机构地区：[1]山东大学第二医院耳鼻咽喉头颈外科,山东济南250033

出　　处：《山东大学耳鼻喉眼学报》2017年第5期95-100,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨超声刀扁桃体切除术与低温等离子扁桃体切除术的优缺点、安全性及可行性。方法计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库和Pubmed等数据库中国内外关于超声刀扁桃体切除术与低温等离子扁桃体切除术的随机对照试验。运用Rev Man 5.3软件对两种手术方式在术中、术后指标进行Meta分析。结果共纳入8个随机对照试验,共722例患者。超声刀扁桃体切除术与低温等离子扁桃体切除术相比,术后出血率明显降低[SMD=0.30,95%CI(0.15,0.600.11,0.79),P=0.010 007],而在手术时间、术中出血量、术后白膜开始脱落时间及术后疼痛评分等方面,超声刀组与等离子组差异无统计学意义。结论超声刀扁桃体切除可明显降低患者术后原发或继发出血的概率,改善患者术后的生活质量。Objective To compare the efficacy,safety,and feasibility of harmonic scalpel and coblation tonsillectomy procedures. Methods A search for randomized controlled trials of harmonic scalpel tonsillectomy and plasma tonsillectomy was carried out in the CNKI,CBM,Wanfang,and Pubmed databases. The retrieved literature was evaluated and Rev Man 5.3 software was used for Meta-analysis of the intra-and post-operative findings of the two kinds of surgical techniques. Results A total of 8 studies involving 722 patients were included. Meta-analysis showed that compared to plasma tonsillectomy,harmonic scalpel tonsillectomy had a reduced postoperative bleeding rate [SMD = 0. 30,95% CI（ 0.15,0.60）,P= 0.000 7]. The operation time,intraoperative bleeding,albuginea shedding time after the operation,and postoperative pain score were not significantly different between the two groups. Conclusion Harmonic scalpel tonsillectomy can significantly reduce the postoperative bleeding rate and improve postoperative quality of life.

关 键 词：扁桃体切除术 超声刀 低温等离子 治疗结果 META分析 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]