低温等离子辅助下儿童腺样体、扁桃体手术并发症分析  

Complications analysis of adenoidectomy and tonsillectomy assisted with ablation on children

作　　者：孙宝春[1] 王丰[1] 杨淑芝[1] 韩泽利[1] 韩佳宏[1] 沈瑶[1] 严清红[1] 周成勇[1] 

机构地区：[1]解放军总医院第一附属医院耳鼻咽喉科,北京100048

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第22期1720-1723,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析低温等离子辅助儿童腺样体、扁桃体手术的并发症情况。方法:对2 089例低温等离子辅助下儿童腺样体、扁桃体手术病例进行回顾性分析,采用流行病学方法对病例人群的一般情况、手术方式、术中及术后并发症情况进行调查分析。结果:(1)2 089例病例中,男1 411例,女678例,男女比例2.08:1;年龄(5.87±3.12)岁,其中3~7岁最多,占76.35%(1 595/2 089)。(2)全部病例均行腺样体切除术,扁桃体采用部分切除术69.17%(1 445/2 089),单纯打孔扁桃体消融术占22.26%(465/2 089),扁桃体全切除术占8.57%(179/2089);手术时间(30.15±8.26)min,术中出血量(8.52±3.18)ml,术后疼痛评分(3.77±1.61)分。(3)术后并发症的发生情况为出血5例(0.24%)、复发3例(0.14%)、椎前淋巴结炎20例(0.96%)、其他6例(圆枕增生2例、呼吸困难2例、烫伤1例、鼻咽粘连1例,0.29%),术后发热205例(9.81%)。结论:低温等离子技术是一治疗儿童腺样体、扁桃体疾病的高效、低并发症的好方法。但提高手术操作熟练程度及技巧是减少并发症的重要环节。Objective：To analyze the complications of adenotonsilectomy assisted with coblation in children.Method：Complications of 2 089 cases of children with adenoid and tonsil surgery assisted with coblation,in our hospital nearly 10 years,were analyzed by epidemiological methods through the method of retrospective analysis.Result：（1）the sex ratio of male to female was 2.08：1,average age（5.87±3.12）years old,and most of 2 089 cases 76.35%（1 595/2 089）were 3-7 years old;（2）all cases underwent adenoidectomy.Different surgery methods of tonsil consisted of three groups as partial resection associated with ablation was 69.17%（1 445/2 089）,ablation（channeling）alone was 22.26%（465/2 089）and total resection was 8.57%（179/208）.The amount of bleeding in operation was（8.52±3.18）ml,average operation time was（30.15±8.26）minutes,the postoperative pain score was（3.77±1.61）;（3）The incidence of postoperative complications：postoperative bleeding（all were secondary bleeding cases）rate was 0.24%（5/2 089）,recurrence rate was 0.14%（3/2 089）,prevertebral lymphadenitis was 0.96%（20/2 089）,the other was 0.29%（torus hyperplasia in 2 cases,dyspnea in 2 cases,1 cases of angle of mouth burned,nasopharyngeal adhesion in 1 cases）.Postoperative fever rate was 9.81%（205/2 089）.Conclusion：coblation technique is a good method for the treatment of childrens adenoids and tonsil diseases with high efficiency and low complications.But improving the operation procedure proficiency level and skills of operation is an important link to reduce complications.

关 键 词：儿童 低温等离子 腺样体 扁桃体 并发症 

分 类 号：R766[医药卫生—耳鼻咽喉科]