Mitic S, Tvinnereim M, Lie E, Saltyte B J
ENT Department, Akershus University Hospital, Oslo, Norway.
Clin Otolaryngol. 2007 Aug;32(4):261-7. doi: 10.1111/j.1365-2273.2007.01468.x.
To compare postoperative recovery in children between 4 and 12 years undergoing tonsillectomy, using either coblation tonsillectomy or dissection tonsillectomy with bipolar diathermy haemostasis.
A prospective, single blind, randomised controlled trial.
ENT clinic, University Teaching Hospital.
Forty paediatric patients, aged between 4 and 12 years and between 16 and 60 kg in weight with standard indication for tonsillectomy.
Patients were randomly allocated to either coblation tonsillectomy or dissection tonsillectomy groups. Patients, parents, and nurses were blinded for operation method. Parents were asked to fill out a postoperative diary from 1 to 10 days.
Primary outcomes were scored for postoperative pain, nutrition, activity, and use of analgetics for each of the 10 postoperative days. Secondary outcomes were estimated from the nurses' postoperative data and 10-day follow-up statistics regarding crossing of the two-score limit.
The groups were statistically comparable by age, weight and operation type. There was no significant difference in operation time in two groups. Intra-operative bleeding was significantly less in the coblation group. Statistically significant differences between dissection tonsillectomy and coblation tonsillectomy were found in the day when a score of two of five was passed in pain scores (9.6 versus 6.2), nutrition scores (8.9 versus 6.6), activity score (8.4 versus 6.6) and medicine intake (9.4 versus 6.4), We found parallelism, between regression lines, that indicates better postoperative life quality for the coblation tonsillectomy group and approximately 2 days' shorter recovery time.
In our pilot study, patients undergoing coblation tonsillectomy reported less pain, quicker return to normal diet, quicker return to normal activity, and less use of analgetics over a 10-day period than patients undergoing dissection tonsillectomy. Our results indicate that the recovery period for coblation tonsillectomy was approximately 2 days shorter and demonstrated less morbidity.
比较4至12岁接受扁桃体切除术的儿童，采用低温等离子扁桃体切除术或双极电凝止血剥离扁桃体切除术的术后恢复情况。
一项前瞻性、单盲、随机对照试验。
大学教学医院耳鼻喉科门诊。
40名儿科患者，年龄在4至12岁之间，体重在16至60公斤之间，有扁桃体切除术的标准指征。
患者被随机分配到低温等离子扁桃体切除术组或剥离扁桃体切除术组。患者、家长和护士对手术方法不知情。要求家长填写术后1至10天的日记。
主要结局指标是对术后10天中每天的术后疼痛、营养、活动及镇痛药使用情况进行评分。次要结局是根据护士的术后数据及关于越过两分界限的10天随访统计数据进行评估。
两组在年龄、体重和手术类型方面具有统计学可比性。两组手术时间无显著差异。低温等离子组术中出血明显更少。在疼痛评分（9.6对6.2）、营养评分（8.9对6.6）、活动评分（8.4对6.6）和药物摄入（9.4对6.4）达到五分制中的两分的天数方面，剥离扁桃体切除术和低温等离子扁桃体切除术之间存在统计学显著差异。我们发现回归线之间具有平行性，这表明低温等离子扁桃体切除术组术后生活质量更好，恢复时间缩短约2天。
在我们的初步研究中，与接受剥离扁桃体切除术的患者相比，接受低温等离子扁桃体切除术的患者在10天内报告的疼痛更少、更快恢复正常饮食、更快恢复正常活动且镇痛药使用更少。我们的结果表明，低温等离子扁桃体切除术的恢复期缩短约2天，且发病率更低。
