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扁桃体切除术中丝线结扎与透热凝固止血的比较:两种技术在术后24小时内疗效的对比

Control of bleeding by silk ligation and diathermy coagulation during tonsillectomy: A comparison of efficacy of the two techniques in the first 24 hours after surgery.

作者信息

Anwar Khurshid, Ahmad Rafiq, Khan Muneeb

机构信息

Khurshid Anwar, Senior Registrar, Department of ENT and Head & Neck Surgery, Hayatabad Medical complex, Peshawar, Pakistan.

Rafiq Ahmad, Associate Professor, Department of ENT and Head & Neck Surgery, Khalifa Gul Nawaz Teaching Hospital Bannu, Pakistan.

出版信息

Pak J Med Sci. 2015 Jul-Aug;31(4):961-4. doi: 10.12669/pjms.314.7445.

Abstract

OBJECTIVE

To assess and compare the relative efficacy of silk ligation and diathermy coagulation techniques in controlling bleeding during tonsillectomy in the first 24 hours.

METHODS

This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital, Bannu and this department related consultants' private clinics from January 1, 2012 to December 31, 2014. The study included 180 cases. All patients included were having history of recurrent, acute tonsillitis, with more than 6-7 episodes in one year, five episodes per year for two years, or three episodes per year for three years. All the surgeries were performed by dissection method. Haemostasis during the procedure was secured by either ligation with silk 1 or using diathermy. The results were analyzed using SPSS 16.0 for windows.

RESULTS

A total of180 cases were included in the study. The ages of the patients ranged from 5 to 40 years with the mean age of 15.56 years and a std.deviation of +/- 8.24. The male to female ratio was 1.25:1. The number of hemorrhages occurring was greater in the 'diathermy coagulation' group as compared to the 'silk ligation' group. However, the observed difference was statistically insignificant (p >.05).

CONCLUSION

Primary haemorrhage occurring during tonsillectomy is a serious threat and control of bleeding during the procedure should therefore be meticulous. Both suture ligation and coagulation diathermy for control of bleeders during the procedure by dissection method are equally effective.

摘要

目的

评估并比较丝线结扎术和透热凝固术在扁桃体切除术后24小时内控制出血的相对疗效。

方法

本前瞻性研究于2012年1月1日至2014年12月31日在班努市哈利法·古尔·纳瓦兹教学医院耳鼻喉科及该科室相关顾问的私人诊所进行。该研究纳入了180例病例。所有纳入的患者均有复发性急性扁桃体炎病史,一年发作超过6 - 7次,或两年内每年发作5次,或三年内每年发作3次。所有手术均采用剥离法进行。手术过程中的止血通过丝线1结扎或使用透热法实现。使用Windows版SPSS 16.0对结果进行分析。

结果

该研究共纳入180例病例。患者年龄在5至40岁之间,平均年龄为15.56岁,标准差为±8.24。男女比例为1.25:1。与“丝线结扎”组相比,“透热凝固”组发生出血的次数更多。然而,观察到的差异无统计学意义(p > 0.05)。

结论

扁桃体切除术中发生的原发性出血是一个严重威胁,因此手术过程中的出血控制应细致入微。在采用剥离法进行手术时,缝线结扎和透热凝固控制出血同样有效。

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本文引用的文献

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