Department of Otorhinolaryngology, Beilun People's Hospital, Beilun District, Ningbo, 315800, Zhejiang Province, China.
Department of Otorhinolaryngology, Beilun People's Hospital, Beilun District, Ningbo, 315800, Zhejiang Province, China.
Int J Pediatr Otorhinolaryngol. 2024 Nov;186:112143. doi: 10.1016/j.ijporl.2024.112143. Epub 2024 Oct 20.
We aimed to compare the effects of microdebrider adenoidectomy, curettage adenoidectomy through oral cavity under 70°endoscope, and endoscopic transoral low-temperature ablation on adenoid hypertrophy.
A total of 180 children suffering from adenoid hypertrophy hospitalized during November 2019 and November 2023 were allocated to group A (microdebrider adenoidectomy, n = 65), group B (curettage adenoidectomy through oral cavity under 70° nasal endoscope, n = 54), and group C (nasal endoscopic transoral low-temperature adenoid ablation, n = 61). The operation data (operation time and bleeding amount), pain score, postoperative recovery, and complications were compared.
The operation time of group A was significantly shorter than those of other two groups, while group C had a significantly smaller bleeding amount than those of other two groups (P < 0.05). An incidence rate of secondary bleeding at 6.15 % was detected in group A, without other complications. Group B had an adenoid residual rate of 35.19 % and a recurrence rate of 14.81 %, significantly exceeding those of other two groups (P < 0.05). The soft palate injury rate was 24.59 % in group C, which was raised significantly compared with those of other two groups (P < 0.05). In comparison to other two groups, significant increases in postoperative pain score and pain duration were detected in Group C (P < 0.05).
There is no significant difference in the effective rate among the three methods. Nasal endoscopic transoral low-temperature adenoid ablation is recommended as the first choice because of small bleeding amount, few postoperative residuals, and low recurrence rate, but it poses high requirements on the operation of doctors.
比较分析电动吸切器腺样体切除术、70°鼻内镜经口腔腺样体刮除术与内镜下经口低温消融术治疗腺样体肥大的效果。
选取 2019 年 11 月至 2023 年 11 月期间我院收治的 180 例腺样体肥大患儿，分为 A 组（电动吸切器腺样体切除术，n=65）、B 组（70°鼻内镜经口腔腺样体刮除术，n=54）和 C 组（内镜下经口低温消融术，n=61）。比较三组患儿的手术相关指标（手术时间、术中出血量）、疼痛评分、术后恢复情况和并发症。
A 组手术时间显著短于其他两组，术中出血量显著少于其他两组（P<0.05）。A 组有 1 例（1.54%）患儿出现继发性出血，无其他并发症。B 组患儿的腺样体残留率和复发率分别为 35.19%、14.81%，显著高于其他两组（P<0.05）。C 组软腭损伤发生率为 24.59%，显著高于其他两组（P<0.05）。与其他两组相比，C 组患儿术后疼痛评分和疼痛持续时间均显著升高（P<0.05）。
三种方法的有效率无显著差异。鼻内镜下经口低温消融术出血量少、术后残留少、复发率低，推荐作为首选，但对术者操作要求较高。
