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儿童低温等离子体扁桃体切除术后扁桃体组织的术后发病率及组织病理学特征:一项前瞻性随机单盲研究

Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children: a prospective randomized single-blind study.

作者信息

Roje Zeljka, Racić Goran, Dogas Zoran, Pisac Valdi Pesutić, Timms Michael

机构信息

University Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital "Split", Split, Croatia.

出版信息

Coll Antropol. 2009 Mar;33(1):293-8.

Abstract

The aim of this prospective randomized single blind study was to determine the depth of thermal damage to tonsillar tissue due to coblation, and to compare it with thermal damage to tonsillar tissue following conventional tonsillectomy; to correlate the depth of thermal damage to tonsillar tissue with the parameters of postoperative morbidity, to compare intraoperative blood loss, postoperative pain severity, time to resuming normal physical activity, and incidence of postoperative bleeding between two groups of tonsillectomized children aged up to 16 years. 72 children aged 3-16 years scheduled for tonsillectomy randomly assigned into two groups submitted either to conventional tonsillectomy with bipolar diathermy coagulation or to coblation tonsillectomy, with a 14-day follow up. Statistically significant differences were observed in the depth of thermal damage to tonsillar tissue (p < 0.001), intraoperative blood loss (p < 0.004), in postoperative pain severity (p < 0.05) and in time to resuming normal physical activity between the two groups (p < 0.001). There was no case of reactionary or secondary bleeding in either group. In this paper for the first time we have correlated postoperative morbidity and thermal tissue damage: less thermal damage is associated with less postoperative morbidity.

摘要

这项前瞻性随机单盲研究的目的是确定低温等离子消融术对扁桃体组织造成的热损伤深度,并将其与传统扁桃体切除术后扁桃体组织的热损伤进行比较;将扁桃体组织的热损伤深度与术后发病率参数相关联,比较两组16岁以下接受扁桃体切除术儿童的术中失血量、术后疼痛严重程度、恢复正常体力活动的时间以及术后出血发生率。72名3 - 16岁计划接受扁桃体切除术的儿童被随机分为两组,分别接受双极电凝常规扁桃体切除术或低温等离子消融扁桃体切除术,并进行为期14天的随访。两组在扁桃体组织热损伤深度(p < 0.001)、术中失血量(p < 0.004)、术后疼痛严重程度(p < 0.05)以及恢复正常体力活动的时间(p < 0.001)方面存在统计学上的显著差异。两组均未出现继发性出血或反应性出血病例。在本文中,我们首次将术后发病率与热组织损伤相关联:热损伤越小,术后发病率越低。

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