单极电刀凝切法切除扁桃体手术创面转归观察  

Observation on the Outcome of the Resection of Tonsillectomy with a Monopolar Electrocautery

作　　者：王建武[1] 饶青[1] 张亚龙[1] 陆丽娟[1] 吴培培[1] WANG Jianwu;RAO Qing;ZHANG Yalong;LU Lijuan;WU Peipei(Department of Otolaryngology,Guannan County of People's Hospital of Jiangsu,Guannan 222500,China)

机构地区：[1]江苏省灌南县人民医院耳鼻咽喉科,江苏灌南222500

出　　处：《中国医药指南》2020年第29期20-21,24,共3页Guide of China Medicine

摘　　要：目的观察比较单极电刀凝切法切除扁桃体手术创面转归情况。方法选择2012年1月至2016年8月在我科住院的36例需行双侧扁桃体切除的患者随机一侧行单极电刀凝切法,另一侧行传统剥离法,观察术后创面愈合转归情况。结果两种术式在原发性出血例数、白膜形成时间、术后白膜脱落时间上无明显差异(P>0.05),但电刀凝切法创面白膜明显厚重颜色偏黄;电刀凝切法术中出血量、术程时间少于传统剥离法,而继发性出血例数、创面损伤深度、术后疼痛评分、愈合不良例数高于传统剥离法(P<0.05)。结论使用单极电刀凝切法切除扁桃体具有操作简便、术中出血少、术野清晰、手术时间短、成本低、配置普及等优点,值得临床应用,但其缺点不容忽视,操作过程中需秉持认真、谨慎的态度,变通操作方法,方能扬长避短,有效降低热损伤带来的负面影响。Objective To compare the outcome of the resection of the wound of tonsillectomy by a monopolar electroknife.Methods The cutting method in our hospital 36 patients underwent bilateral tonsillectomy were randomly performed unilateral monopolar electrocautery coagulation in January 2012 to August 2016,on the other side of the traditional stripping method,observation of postoperative wound healing outcome.Results There was no significant difference in the number of primary hemorrhage cases,the formation time of the tunica albuginea,and the time of postoperative tunica albuginea shedding between the two surgical methods(P>0.05),but the tunica albuginea on the wound with electrosurgical coagulation was thick and yellowish;the amount of blood loss and the operation time of the coagulation method were less than those of the traditional stripping method,while the number of cases of secondary bleeding,the depth of wound injury,the postoperative pain score,and the number of cases of poor healing were higher than that of the traditional stripping method(P<0.05).Conclusion The use of monopolar electrocoagulation tonsillectomy has the advantages of simple operation,less bleeding,clear field of operation,short operation time,low cost,configuration popularization and other advantages,is worthy of clinical application,but its disadvantages should not be ignored in the process of operation,the need to uphold conscientious,cautious attitude,flexible operation method,can effectively avoid,and to reduce the negative effects brought by thermal damage.

关 键 词：扁桃体切除术 创面转归 单极电刀凝切法 传统剥离法 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]