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儿童手术中低温等离子辅助扁桃体切除术与传统剥离扁桃体切除术的比较

[Low-temperature coblation-assisted versus conventional dissection tonsillectomy in surgeries for children].

作者信息

Wang Jie, Liu Dabo, Huang Zhenyun, Zhong Jianwen, Tan Zongyu, Qiu Shuyao

机构信息

Department of Otolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou, 510120, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Aug;23(15):690-2.

Abstract

OBJECTIVE

To compare low temperature coblation assisted tonsillectomy with conventional dissection tonsillectomy intra-operation and after-operation.

METHOD

Ninety-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocine EVac 70 T&A Wand was used for coblation-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded separately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of after-operation.

RESULT

Coblation assisted group had a shorter operative time than the control group (10.2 min vs. 36.5 min, P<0.001). The average amount of intraoperative bleeding of Coblation assisted group was (6.83+/-3.36) ml, while the control group was (30.07+/-7.04) ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group,who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation.

CONCLUSION

Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding, shorter operation time, earlier return to normal diet, less pain on 1st to 3rd day postoperatively.

摘要

目的

比较低温等离子辅助扁桃体切除术与传统剥离法扁桃体切除术的术中和术后情况。

方法

将92例儿科患者随机分为低温等离子辅助扁桃体切除术组和对照组。使用Arthrocine EVac 70 T&A Wand进行低温等离子辅助扁桃体切除术,能量设置为7。对照组行传统剥离法扁桃体切除术。分别记录手术时间、出血量、扁桃体窝愈合情况、恢复正常饮食和活动的时间以及术中并发症。术后10天每天使用面部表情疼痛量表记录儿科患者的术后疼痛情况。

结果

低温等离子辅助组的手术时间比对照组短(10.2分钟对36.5分钟,P<0.001)。低温等离子辅助组术中平均出血量为(6.83±3.36)毫升,而对照组为(30.07±7.04)毫升。低温等离子组的儿科患者在术后1、2、3天的疼痛评分优于对照组,两组在术后4至10天无统计学显著差异。低温等离子组患者恢复正常饮食的时间比对照组早,但两组恢复正常活动所需时间相似。对照组有1例患者在术后第6天因口咽活动性出血需要缝合止血。

结论

与传统剥离法相比,低温等离子辅助扁桃体切除术操作简便,术中出血少,手术时间短,恢复正常饮食早,术后第1至3天疼痛轻。

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