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一项前瞻性、随机、单盲、对照研究,旨在比较两种腺样体切除术的方法。

Prospective, randomized, single-blind, controlled study to compare two methods of performing adenoidectomy.

作者信息

Jonas N E, Sayed Rauf, Prescott C A J

机构信息

Division of Otolaryngology, University of Cape Town Medical School, H-53 Old Main Building, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa.

出版信息

Int J Pediatr Otorhinolaryngol. 2007 Oct;71(10):1555-62. doi: 10.1016/j.ijporl.2007.06.008. Epub 2007 Jul 12.

Abstract

OBJECTIVE

To compare adenoidectomy using suction-diathermy ablation to curettage adenoidectomy with respect to operative time and adenoid regrowth at 6 months after surgery.

STUDY DESIGN

A prospective, randomized, single-blind, study to compare two methods of performing adenoidectomy. A group of 100 children, undergoing adenoidectomy alone or in combination with tonsillectomy, were randomized into two groups and underwent either suction diathermy or curettage adenoidectomy by a single surgeon.

SETTING

A tertiary care Paediatric Hospital.

METHOD

Indication for surgery, adenoidal size, duration of surgery and complications were recorded and compared. Six-month follow-up was conducted and adenoidal size and symptom status were recorded and compared. Statistical analysis was performed using Microsoft Excel.

RESULTS

One hundred patients participated in this study and underwent adenoidectomy alone or adenotonsillectomy. Ninety-two patients returned for follow-up and 91 patients completed the study. The two treatment groups were well matched for age and gender. The main indications for both groups were snoring, nasal obstruction and obstructive sleep apnoea. For adenoidectomy alone there was no significant difference in duration of surgery between the curette and suction diathermy groups. When performing tonsillectomy and adenoidectomy together suction diathermy took significantly longer to complete than curettage (P<0.001). Overall 96% of patients' symptoms had either improved or resolved. The post-operative comparison at 6 months showed a significant difference in the residual adenoidal size between the two groups, the suction diathermy group being generally smaller than the curettage group.

CONCLUSIONS

Suction diathermy was better at reducing the adenoidal size 6 months after surgery. Although the difference in size was statistically significant it did not seem to be of clinical significance.

摘要

目的

比较使用吸引-透热消融术行腺样体切除术与刮除术式腺样体切除术在手术时间及术后6个月腺样体再生长方面的差异。

研究设计

一项前瞻性、随机、单盲研究,比较两种腺样体切除手术方法。100例单纯行腺样体切除术或同时行扁桃体切除术的儿童被随机分为两组,由同一位外科医生分别实施吸引透热消融术或刮除术式腺样体切除术。

研究地点

一家三级儿科医院。

方法

记录并比较手术指征、腺样体大小、手术时长及并发症情况。进行6个月的随访,记录并比较腺样体大小及症状状况。使用Microsoft Excel进行统计分析。

结果

100例患者参与本研究,接受了单纯腺样体切除术或腺样体扁桃体切除术。92例患者返回进行随访,91例患者完成研究。两个治疗组在年龄和性别方面匹配良好。两组的主要指征均为打鼾、鼻塞和阻塞性睡眠呼吸暂停。对于单纯腺样体切除术,刮除组和吸引透热消融组在手术时长上无显著差异。当同时进行扁桃体切除术和腺样体切除术时,吸引透热消融术完成手术的时间明显长于刮除术(P<0.001)。总体而言,96%的患者症状得到改善或缓解。术后6个月的比较显示,两组之间残留腺样体大小存在显著差异,吸引透热消融组通常小于刮除组。

结论

吸引透热消融术在术后6个月时能更好地减小腺样体大小。尽管大小差异在统计学上具有显著性,但似乎并无临床意义。

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