鼻内镜下不同径路在儿童腺样体肥大切除术中的应用  

Application of Different Approaches under Nasal Endoscope in Adenoid Hypertrophy Resection in Children

作　　者：吴海导 胡永成 陈国锋 邓成柳 WU Haidao;HU Yongcheng;CHEN Guofeng;DENG Chengliu(Yunfu People’s Hospital, Yunfu 527300, China)

机构地区：[1]云浮市人民医院,广东云浮527300

出　　处：《中外医学研究》2020年第8期28-30,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广东省云浮市卫生和计划生育局科研项目(项目编号:2018B03)。

摘　　要：目的:对比鼻内镜下经鼻腔径路和口腔径路行腺样体肥大切除术的效果,分析两种径路的优缺点,为临床制定更有效的治疗方案提供参考.方法:选取2016年7月-2019年8月笔者所在医院收治的腺样体肥大患儿42例,随机分为A组和B组,各21例.A组经口腔径路行腺样体肥大切除术,B组经鼻腔径路行腺样体肥大切除术.对两组术中出血量、疼痛评分、术后并发症进行分析.结果:术后,两组临床症状完全缓解;术后7 d复查,两组均无腺样体残留且恢复正常通气;A组术中出血量少于B组,差异有统计学意义(P<0.05);两组术后1 d疼痛评分比较,差异无统计学意义(P>0.05);B组术后轻度间歇鼻塞2例,中度悬雍垂水肿1例,并发症发生率为14.29%,显著高于A组(P<0.05).结论:经口腔径路行儿童腺样体肥大切除术,能够确保刀口朝向腺样体方向,边切割边利用吸引力将腺体组织吸入吸切器,操作简单方便,术野清晰,创面光滑,能够有效保护周围正常组织,减少并发症,值得推广.Objective:To compare the effect of adenoid hypertrophy resection through nasal and oral approaches under nasal endoscope,and the advantages and disadvantages of the two approaches were analyzed to provide a reference for the clinical development of more effective treatment programs.Method:From July 2016 to August 2019,42 children with adenoid hypertrophy admitted to our hospital were randomly divided into the group A and the group B,21 cases in each group.Adenoid hypertrophy resection through oral approaches was performed in the group A,and adenoid hypertrophy resection through nasal approaches was performed in the group B.The intraoperative blood loss,pain score and postoperative complications of the two groups were analyzed.Result:After operation,the clinical symptoms of the two groups were completely relieved,and reexamination after operation showed that there was no residual adenoids in the two groups and normal ventilation was restored.The intraoperative blood loss in the group A was less than that of the group B,and the difference was statistically significant(P<0.05).The pain scores 1 d after operation compared between the two groups,and the difference was not statistically significant(P>0.05).In the group B,there were 2 cases with mild intermittent nasal obstruction and 1 case with moderate uvula edema after operation,and the incidence of complications was 14.29%,which was higher than that of the group A(P<0.05).Conclusion:Adenoid hypertrophy resection through oral approaches in children can ensure the knife edge is toward the direction of the adenoid,and the adenoid tissue is inhaled into the aspirator by attraction while cutting,which is simple and convenient to operate,clear operative field,smooth wound,and can effectively protect the surrounding normal tissue,reduce the complications,which is worth popularizing.

关 键 词：腺样体 鼻内镜 出血 并发症 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]