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低温等离子消融术:改善儿童腺样体扁桃体切除术后的治疗效果

Coblation: improving outcomes for children following adenotonsillectomy.

作者信息

Benninger Michael, Walner David

机构信息

Department of Otolaryngology-Head and Neck Surgery, Henry Ford Medical Group and Hospital, Detroit, Michigan 48202, USA.

出版信息

Clin Cornerstone. 2007;9 Suppl 1:S13-23. doi: 10.1016/s1098-3597(07)80005-6.

Abstract

Tonsillectomy and adenoidectomy, 2 of the most common childhood surgeries, are performed for a number of indications, the most common being airway obstruction caused by adenotonsillar hypertrophy. Other indications for tonsillectomy include recurrent pharyngotonsillitis, streptococcal carriage, recurrent peritonsillar abscess, halitosis, and presumed neoplasia. Although adenotonsillar surgery is a safe and effective technique for treating disease and obstruction, parents remain concerned about postoperative morbidity, for which the potential is much greater after tonsillectomy than adenoidectomy. Postoperative pain and hemorrhage are 2 unpleasant side effects that can prolong postoperative recovery. Surgeons use a variety of surgical techniques to remove the tonsils and adenoids. When compared with older techniques, such as cold steel dissection and monopolar electrocautery, a new technique named Coblation that uses lower temperatures than electrocautery to remove tonsil tissue and achieve hemostasis, has been shown to reduce pain and decrease postoperative narcotic use, leading to shorter recovery times and a quicker return to normal in children.

摘要

扁桃体切除术和腺样体切除术是儿童最常见的两种手术,其施行有多种指征,最常见的是腺样体扁桃体肥大引起的气道阻塞。扁桃体切除术的其他指征包括复发性咽扁桃体炎、链球菌携带、复发性扁桃体周脓肿、口臭以及疑似肿瘤。尽管腺样体扁桃体手术是治疗疾病和阻塞的一种安全有效的技术,但家长们仍担心术后发病率,扁桃体切除术后的潜在发病率比腺样体切除术后要高得多。术后疼痛和出血是两种令人不适的副作用,会延长术后恢复时间。外科医生使用多种手术技术来切除扁桃体和腺样体。与诸如冷钢剥离术和单极电烙术等传统技术相比,一种名为低温等离子消融术(Coblation)的新技术,其使用的温度低于电烙术来切除扁桃体组织并实现止血,已被证明能减轻疼痛并减少术后麻醉剂的使用,从而使儿童恢复时间更短,更快恢复正常。

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