经口-鼻内窥镜引导下腺样体刮除术及手术指征探讨  

Adenoidectomy Directed by Transoral - nasoendoscopy and Surgical Indication

作　　者：刘洪英[1] 魏丽萍[1] 张春丽[1] 许朝霞[1] 蔡晓岚[2] 

机构地区：[1]济南铁路中心医院耳鼻咽喉科,济南市250001 [2]山东大学卫生部耳鼻咽喉科学重点实验室,济南市250000

出　　处：《中国厂矿医学》2003年第3期185-187,共3页Chinese Medicine of Factory and Mine

摘　　要：目的:对腺样体刮除术的手术指征和手术径路进行探讨。方法:回顾性分析49例手术患者的临床资料,其主诉以睡眠不安、打鼾、憋气、张口呼吸、鼻塞、经常性咽痛、多涕、反复听力下降为主;根据手术径路的不同分为传统组(15例)和经口-鼻内窥镜组(34例)。结果:术后13d,患者睡眠呼吸恢复正常,2～6周后听力较术前提高10～30dB,术后3个月纤维鼻咽镜检查:经口-鼻内窥镜组无腺样体残留。结论:纤维鼻咽镜检查及头颅侧位摄片有助于手术适应证的确定,经口-鼻内窥镜引导下腺样体刮除术具有直视下操作,视野清晰、开阔,切除彻底,可避免损伤周围重要结构的特点。Objective:To discuss adenoidectomy about surgical indication and approach. Methods: Retrospective analysis were the clinical data of 49 surgical cases. Their complaints were mainly about restless sleep, snore, struggle to breathe, mouth breathing, nasal obstruction , often pharyngeal pain, more nasal discharge and recurrent hearing decrease. According to the different surgical approach, the patients were divided into two groups:one is conventional approach( 15cases) ,another is transoral - nasoendoscopy(34cases). Results:The patients's sleep respiration were recovery after 1 to 2 days. After 2 to 6 weeks, hearing was elevated 10 - 30 dB compared with preoperation. After 3 months follow up, no residual body was found in transoral - nasoendoscopy group through examination of nasopharyngeal endoscopy. Conclusions:Fibrous endoscopy and lateral view skull radiographic examination are helpful to confirm the surgical indication. Transoral -nasoendoscopy allow the operation under direct, clear and open visualization. Using this approach, adenoid tissue can be removed completely without damage to peripheral structures.

关 键 词：经口-鼻内窥镜引导 腺样体刮除术 手术指征 手术径路 术后检查 腺样体肥大 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]