鼻内镜下单极电刀切除儿童扁桃体的临床观察

Clinical observation on children tonsillectomy tonsil with single pole electric knife under nasal endoscopy

摘要:

目的??通过鼻内镜下单极高频电刀切除儿童扁桃体，观察术中、术后相关指标，评价手术疗效，并与传统扁桃体剥离术相比较。方法?选择4～9岁儿童40例，严格根据扁桃体切除手术指征，完善相关必要术前检查，排除手术禁忌证，鼻内镜下单极高频电刀切除扁桃体手术，观察手术中出血量、手术持续时间、术后疼痛、术后伪膜生长情况和术后出血情况，传统扁桃体剥离手术方式选择40例患儿。结果?通过鼻内镜手术组患者手术时间、术中出血量均明显低于传统扁桃体剥离组（P <0.05），鼻内镜组术后无出血，传统扁桃体剥离组1例迟发性出血，术后疼痛持续时间、术后疼痛程度和白色伪膜脱落时间两组之间比较差异无统计学意义（P >0.05）。结论?鼻内镜下进行单极高频电刀切除儿童扁桃体过程中出血少，手术操作时间短，手术视野清楚，周围组织损伤小，伤口恢复快，能有效减少患儿痛苦，值得临床应用。

Abstract:

Objective?To evaluate the effect of utilizing nasal endoscope in tonsillectomy for children with monopolar electrical cauter, and compared with the traditional tonsillectomy by dissection. Methods?40 cases of children were selected between the ages of 4 and 9,strictly according to the tonsillectomy indications, perfect the relevant preoperative examination, there was not operation contraindication, utilizing nasal endoscope in tonsillectomy for children with monopolar electrical cauter, observation index included hemorrhage in operation, operation time, ache after operation, inflammatory reaction of raw surface, hemorrhage in postoperation. The other 40 cases got the traditional tonsillectomy by dissection. Results?By patients with nasal endoscopic surgical operation time, intraoperative blood loss were significantly lower than the traditional tonsil stripping group (P <0.05). Nasal endoscopy group was no postoperative bleeding, traditional tonsillectomy by dissection group had 1 case of delayed hemorrhages, duration of postoperative pain, postoperative pain degree and white pseudo membrane shedding time were no obvious statistical significance differences between the two groups (P >0.05). Conclusion?Under nasal endoscope for unipolar electrosurgical excision tonsil surgery less bleeding, shorter operative time, clear operative field, small damage, rapid recovery, can effectively reduce the pain of patients, it is worthy of promoting clinical application.