Department of ENT, Head and Neck Surgery, General Hospital Dr. Josip Benčević, Andrije Štampara 42, 35000, Slavonski Brod, Croatia,
Wien Klin Wochenschr. 2013 Sep;125(17-18):524-8. doi: 10.1007/s00508-013-0411-6. Epub 2013 Aug 10.
Tonsillectomy is a very painful procedure. Pain may be severe, and patients are often unable to perform in school or eat regular food for a number of days after the surgery. The aim of this study was to compare the quality of life after undergoing two different surgical techniques of tonsillectomy, harmonic scalpel and classic tonsillectomy with bipolar cauterization.
Prospective randomized double-blind, clinical trial study conducted in the ENT Department, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia.
Data were collected, according to the type of operation, on pain persistence and intensity and returning to normal eating with tonsillectomy patients during the first seven postoperative days. Group A consisted of 50 children submitted to classic tonsillectomy with bipolar cauterization, while group B included 50 children operated on using the harmonic scalpel. Data on pain intensity were obtained using pain measuring scales adjusted to children's age (Faces scales, visual analog scale). The first day of normal oral food intake was recorded.
The analysis of variance revealed that the grade of pain significantly differs by a surgical technique employed, and that it significantly varied over the first seven postoperative days. The pain was more severe after undergoing the harmonic scalpel technique and children started to eat later compared with the classic tonsillectomy.
The classic tonsillectomy method with bipolar cauterization is the method of choice due to lower postoperative pain levels and sooner normal eating. The quality of life is better after undergoing the classic tonsillectomy method.
扁桃体切除术是一种非常痛苦的手术。术后疼痛可能很严重,患者通常在手术后数天内无法上学或正常进食。本研究旨在比较两种不同的扁桃体切除术(超声刀和双极电凝的经典扁桃体切除术)后的生活质量。
在克罗地亚斯拉沃尼亚布罗德的 Josip Benčević 综合医院耳鼻喉科进行的前瞻性随机双盲临床试验研究。
根据手术类型,在术后第 1 至 7 天内收集扁桃体切除术后患者疼痛持续时间和强度以及恢复正常饮食的相关数据。A 组 50 例患儿行经典的双极电凝扁桃体切除术,B 组 50 例患儿行超声刀扁桃体切除术。采用适合儿童年龄的疼痛测量量表(面部量表、视觉模拟量表)获得疼痛强度数据。记录正常口服食物摄入的第一天。
方差分析显示,手术技术的选择显著影响疼痛程度,且在术后第 1 至 7 天内疼痛程度显著不同。与经典的扁桃体切除术相比,行超声刀技术的患者疼痛更严重,且开始进食的时间更晚。
由于术后疼痛程度较低和更早恢复正常饮食,经典的双极电凝扁桃体切除术是首选方法。经典的扁桃体切除术方法可提高生活质量。