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低温等离子体辅助带倒刺前咽成形术(CABAPh)后的术后疼痛与伤口愈合:一项观察性研究

Postoperative Pain and Wound Healing After Coblation-Assisted Barbed Anterior Pharyngoplasty (CABAPh): An Observational Study.

作者信息

Rinaldi Vittorio, Costantino Andrea, Moffa Antonio, Cassano Michele, Mantovani Mario, Casale Manuele, Pignataro Lorenzo

机构信息

1Division of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.

2Unit of Otolaryngology - Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1157-1162. doi: 10.1007/s12070-018-01577-8. Epub 2019 Jan 2.

Abstract

Despite the numerous progresses in the palatal surgery, one of the critical aspect of snoring and OSA surgery is the postoperative pain. Over the last decades several surgical palatal procedures have been proposed. Our aim was to evaluate the tolerability of the coblation-assisted barbed anterior pharyngoplasty (CABAPh) in terms of postoperative pain and wound healing, compared with bipolar assisted barbed anterior pharyngoplasty (BAPh). An observational study on 20 patients with simple snoring was conducted. The outcomes measured to assessing pain were a 10 cm visual analog scale (VAS) and the dose of paracetamol + codeine administrated postoperatively. The wound healing was evaluated using a 3-point scale. The other parameters indicative of both pain and surgical repair were food intake and weight loss postoperatively. The mean overall pain (VAS scale) was significantly less in the CABAPh group (M 3.7; CI 3.34-4.06) compared with the BAPh (M 4.73; CI 4.28-5.19) with a  = 0.003. The mean wound healing after 4 weeks was significantly less in CABAPh group (M 2.7; CI 3.12-2.28) compared with the BAPh (M 2.1; CI 2.45-1.75) with a  = 0.02. There were no statistically significant difference with regard to food intake ( = 0.09) and weight loss ( = 0.94). The CABAPh was able to achieve a greater pain reduction and a faster wound healing compared with bipolar forceps.

摘要

尽管腭部手术取得了诸多进展,但打鼾和阻塞性睡眠呼吸暂停综合征(OSA)手术的一个关键问题是术后疼痛。在过去几十年里,人们提出了几种腭部手术方法。我们的目的是评估与双极辅助带刺前咽成形术(BAPh)相比,低温等离子辅助带刺前咽成形术(CABAPh)在术后疼痛和伤口愈合方面的耐受性。对20例单纯打鼾患者进行了一项观察性研究。评估疼痛的指标包括10厘米视觉模拟量表(VAS)和术后服用对乙酰氨基酚+可待因的剂量。使用三分制量表评估伤口愈合情况。其他表明疼痛和手术修复情况的参数包括术后食物摄入量和体重减轻情况。与BAPh组(中位数4.73;可信区间4.28 - 5.19)相比,CABAPh组的平均总体疼痛(VAS量表)明显更低(中位数3.7;可信区间3.34 - 4.06),P = 0.003。与BAPh组(中位数2.1;可信区间2.45 - 1.75)相比,CABAPh组术后4周的平均伤口愈合情况明显更好(中位数2.7;可信区间3.12 - 2.28),P = 0.02。在食物摄入量(P = 0.09)和体重减轻情况(P = 0.94)方面,两组之间没有统计学上的显著差异。与双极镊相比,CABAPh能够实现更大程度的疼痛减轻和更快的伤口愈合。

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