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超声刀在扁桃体切除术中的应用

[Application of ultracision-harmonic scalpel for tonsillectomy].

作者信息

ZHOU Jie, ZHAI Jin-ming, CHEN Guan-gui, ZHANG Jian-guo

机构信息

Department of Otorhinolaryngology, Second Affiliated Hospital of Guangzhou Medical College, Guangzhou 510260, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Apr;47(4):324-5.

PMID:22800353
Abstract

OBJECTIVE

To investigate the advantages and disadvantages of ultracision-harmonic scalpel assisted tonsillectomy by compared with conventional tonsillectomy.

METHODS

Eighty-eight patients were randomly divided into ultrasonic scalpel group (group A, 42 cases) and control group (group B, 46 cases). The tonsillectomy in group A was performed with ultracision-harmonic scalpel, and in group B, the tonsillectomy was performed by routine method. The surgical time (complete removal of tonsils), blood loss, and postoperative sore throat situation were recorded.

RESULTS

Surgical time in group A [(14.7 ± 4.0) min] was shorter than that in group B [(28.9 ± 7.6) min], t = -10.691, P < 0.05. Blood loss in group A [(3.1 ± 1.1) ml] was less than that in group B [(19.0 ± 5.2) ml], t = -19.544, P < 0.05. Postoperative sore throat was less painful in group A than that in group B in 10 hours after surgery, but much painful than group B 3 days after surgery and most patients lasted longer. There were statistical differences (P < 0.05). The average peel off time for the tunica albuginea was 8 days after the operation by using traditional method, by compared with the ultrasonic scalpel method, average time was 11 days, the difference showed statistical significance (t = 5.115, P < 0.05).

CONCLUSIONS

Compared with traditional tonsillectomy, ultracision-harmonic scalpel tonsillectomy had shorter operative time, less blood loss and so on, but the sore throat symptoms persisted longer. In addition, the tunica albuginea peeled off later, so avoidance of secondary bleeding caused by improper diet was mandatory.

摘要

目的

通过与传统扁桃体切除术对比,探讨超声刀辅助扁桃体切除术的优缺点。

方法

88例患者随机分为超声刀组(A组,42例)和对照组(B组,46例)。A组采用超声刀行扁桃体切除术,B组采用常规方法行扁桃体切除术。记录手术时间(扁桃体完整切除)、出血量及术后咽痛情况。

结果

A组手术时间[(14.7±4.0)分钟]短于B组[(28.9±7.6)分钟],t=-10.691,P<0.05。A组出血量[(3.1±1.1)毫升]少于B组[(19.0±5.2)毫升],t=-19.544,P<0.05。术后10小时A组咽痛程度低于B组,但术后3天A组咽痛程度高于B组,且多数患者持续时间更长。差异有统计学意义(P<0.05)。采用传统方法术后白膜平均脱落时间为8天,超声刀方法术后白膜平均脱落时间为11天,差异有统计学意义(t=5.115,P<0.05)。

结论

与传统扁桃体切除术相比,超声刀扁桃体切除术手术时间短、出血量少等,但咽痛症状持续时间长。此外,白膜脱落较晚,则必须避免因饮食不当导致继发性出血。

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[Application of ultracision-harmonic scalpel for tonsillectomy].超声刀在扁桃体切除术中的应用
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