Horii Arata, Hirose Masayuki, Mochizuki Ryuichi, Yamamoto Keisuke, Kawamoto Masahiro, Kitahara Tadashi, Yamamoto Yoshifumi, Kawashima Takayuki, Uno Atsuhiko, Imai Takao, Nishiike Suetaka, Inohara Hidenori
Department of Otolaryngology, Suita Municipal Hospital, Japan.
Acta Otolaryngol. 2011 Jul;131(7):764-8. doi: 10.3109/00016489.2011.566580. Epub 2011 Apr 19.
Bipolar scissors tonsillectomy followed by cooling down the pharyngeal mucosa has advantages in terms of postoperative pain and intraoperative blood loss compared with cold dissection.
The purpose of this study was to compare the postoperative pain between bipolar scissors tonsillectomy followed by cooling the pharyngeal mucosa and a traditional cold dissection.
A total of 189 patients aged more than 16 years were operated due to habitual tonsillitis, obstructive sleep apnea syndrome, and IgA nephropathy. Of these, 79 patients were operated using bipolar scissors followed by cooling the pharyngeal mucosa with 4°C saline for 10 min just after the removal of tonsils. The other 110 patients underwent cold dissection tonsillectomy. Outcome measures were intraoperative blood loss, operative time, postoperative pain evaluated on a visual analog scale, and postoperative secondary hemorrhage.
Significantly lower levels of intraoperative blood loss and less postoperative pain were obtained in bipolar scissors tonsillectomy followed by cooling the pharyngeal mucosa compared with cold dissection. Postoperative hemorrhage needing hemostatic surgery occurred in 2 of 79 patients who underwent bipolar scissors tonsillectomy with cooling, while it occurred in 1 of 110 patients after cold dissection. However, the difference was not statistically significant.
与冷剥离术相比,双极电凝剪刀扁桃体切除术后对咽黏膜进行降温在术后疼痛和术中失血方面具有优势。
本研究旨在比较双极电凝剪刀扁桃体切除术后对咽黏膜进行降温与传统冷剥离术的术后疼痛情况。
共有189例16岁以上患者因习惯性扁桃体炎、阻塞性睡眠呼吸暂停综合征和IgA肾病接受手术。其中,79例患者使用双极电凝剪刀进行手术,在切除扁桃体后立即用4℃生理盐水对咽黏膜进行10分钟的降温。另外110例患者接受冷剥离扁桃体切除术。观察指标包括术中失血、手术时间、采用视觉模拟评分法评估的术后疼痛以及术后继发性出血。
与冷剥离术相比,双极电凝剪刀扁桃体切除术后对咽黏膜进行降温的术中失血量明显更低,术后疼痛也更少。在79例接受双极电凝剪刀扁桃体切除术并进行降温的患者中,有2例需要进行止血手术的术后出血,而在冷剥离术后110例患者中有1例发生术后出血。然而,差异无统计学意义。