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扁桃体切除术中过氧化氢与肾上腺素的比较效益:一项随机对照研究。

Comparison Benefit between Hydrogen Peroxide and Adrenaline in Tonsillectomy: A Randomized Controlled Study.

作者信息

Hsieh Cheng-Yu, Hsu Chuan-Jen, Wu Hung-Pin, Sun Chuan-Hung

机构信息

Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan.

School of Medicine, Tzu Chi University, Hualien 970, Taiwan.

出版信息

J Clin Med. 2022 May 11;11(10):2723. doi: 10.3390/jcm11102723.

Abstract

This study aimed to further evaluate the benefit of topical hemostasis agents in tonsillectomy. We compared the clinical effects of topical application between hydrogen peroxide and adrenaline in tonsillectomy. Overall, 60 patients (120 tonsils) were prospectively enrolled for tonsillectomy between February 2018 and December 2020. The patients were randomly assigned to either the hydrogen peroxide or adrenaline group. Then, tonsillectomy was performed using hydrogen peroxide as a hemostatic agent on the assigned side, while adrenaline was applied to the other side. All procedures were performed by a surgeon who was blinded to the randomization. The outcome measurements of operation time, intraoperative blood loss, postoperative pain, and hemorrhage events were analyzed. The intraoperative blood loss was significantly lower in the hydrogen peroxide group than in the adrenaline group (9.99 ± 4.51 mL vs. 13.87 ± 6.32 mL; = 0.0). The median operation time was also significantly lower in the hydrogen peroxide group (8.02 ± 3.59 min vs. 9.22 ± 3.88 min; = 0.019). Meanwhile, the visual analogue scale (VAS) scores were significantly higher in the hydrogen peroxide group (4.98 ± 1.94 vs. 4.27 ± 1.97; = 0.001). The topical application of hydrogen peroxide as a hemostatic agent effectively decreases the operation time and intraoperative blood loss. Thus, hydrogen peroxide can be used as a routine hemostatic agent for bleeding control in tonsillectomy.

摘要

本研究旨在进一步评估局部止血剂在扁桃体切除术中的益处。我们比较了过氧化氢和肾上腺素在扁桃体切除术中局部应用的临床效果。总体而言,2018年2月至2020年12月期间,前瞻性纳入了60例患者(120个扁桃体)进行扁桃体切除术。患者被随机分配到过氧化氢组或肾上腺素组。然后,在指定一侧使用过氧化氢作为止血剂进行扁桃体切除术,而另一侧应用肾上腺素。所有手术均由对随机分组不知情的外科医生进行。分析了手术时间、术中出血量、术后疼痛和出血事件等结果指标。过氧化氢组的术中出血量显著低于肾上腺素组(9.99±4.51毫升对13.87±6.32毫升;P = 0.0)。过氧化氢组的中位手术时间也显著更短(8.02±3.59分钟对9.22±3.88分钟;P = 0.019)。同时,过氧化氢组的视觉模拟评分(VAS)显著更高(4.98±1.94对4.27±1.97;P = 0.001)。过氧化氢作为止血剂的局部应用有效缩短了手术时间并减少了术中出血量。因此,过氧化氢可作为扁桃体切除术中控制出血的常规止血剂。

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本文引用的文献

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Hydrogen peroxide (HO): a review of its use in surgery.过氧化氢(HO):其在外科手术中应用的综述
Wien Med Wochenschr. 2019 Jun;169(9-10):222-225. doi: 10.1007/s10354-017-0610-2. Epub 2017 Nov 16.
2
Hydrogen Peroxide: A Potential Wound Therapeutic Target?过氧化氢:一种有潜力的创伤治疗靶点?
Med Princ Pract. 2017;26(4):301-308. doi: 10.1159/000475501. Epub 2017 Apr 5.

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