Willging J Paul, Wiatrak Brian J
Cincinnati Children's Hospital Medical Center, Ohio, USA.
Otolaryngol Head Neck Surg. 2003 Mar;128(3):318-25. doi: 10.1067/mhn.2003.71.
In this randomized prospective study, we evaluated postoperative morbidity after use of the Harmonic Scalpel (HS), an ultrasonic dissector coagulator (Ethicon Endo-Surgery Inc, Cincinnati, OH), or conventional electrocautery (EC) during tonsillectomy.
Pediatric subjects at 2 sites were randomized and underwent tonsillectomy. Intraoperative blood loss and operation duration were recorded. Postoperative parameters and complications were recorded.
One hundred seventeen subjects completed the study. For the HS group, mean operative time was significantly longer (P < 0.001), but intraoperative blood loss was equivalent (P = 1.000). HS subjects slept soundly on postoperative days 1, 2, 3, and 14 (P = 0.041, 0.013, 0.022, and 0.038, respectively, compared with EC group). Mean postoperative pain scores trended lower for HS subjects on postoperative days 2, 3, and 4.
The use of the HS in pediatric tonsillectomy showed no increase in intraoperative or postoperative blood loss compared with the use of EC, and HS provided possible clinical advantages over EC in patient comfort.
Tonsillectomy subjects in the HS group showed a statistically significant ability to sleep soundly, suggesting that the subjects experienced less pain. These data correlate with the observed decrease in pain scores.
在这项随机前瞻性研究中，我们评估了在扁桃体切除术中使用超声刀（HS，一种超声切割凝血器，美国俄亥俄州辛辛那提市的爱惜康内镜外科公司生产）或传统电灼术（EC）后的术后发病率。
来自2个地点的儿科受试者被随机分组并接受扁桃体切除术。记录术中失血量和手术时长。记录术后参数及并发症。
117名受试者完成了研究。对于HS组，平均手术时间显著更长（P < 0.001），但术中失血量相当（P = 1.000）。HS组受试者在术后第1、2、3和14天睡眠良好（与EC组相比，P分别为0.041、0.013、0.022和0.038）。HS组受试者在术后第2、3和4天的平均术后疼痛评分呈下降趋势。
与使用EC相比，在儿科扁桃体切除术中使用HS并未增加术中或术后失血量，并且在患者舒适度方面，HS比EC具有可能的临床优势。
HS组的扁桃体切除术受试者显示出在统计学上有显著的良好睡眠能力，表明受试者经历的疼痛较少。这些数据与观察到的疼痛评分下降相关。
