摘要
目的比较鼻内镜下低温等离子和(或)鼻动力切除腺样体的疗效和安全性,以便更好的指导临床术式选择。方法收集2012年9月~2020年1月我院手术的腺样体肥大患儿共270例,随机分为三组,每组90例:A组-鼻动力组,采用鼻动力切除腺样体,压迫及电凝止血;B组-等离子组,采用低温等离子射频消融切除腺样体;C组-鼻动力联合低温等离子组,采用鼻动力切除腺样体至咽颅底筋膜表面约2mm,后行低温等离子残余腺样体消融止血。结果所有患儿手术顺利,术中术后均未出现并发症,绝大多数患儿术后病情得到治愈。但C组患儿在手术时间方面优于A组和B组,差异有统计学意义(P<0.05);C组患儿在出血量方面优于A组,差异有统计学意义(P<0.05);C组患儿术后6个月OSA-18评分低于A组和B组,差异有统计学意义(P<0.05);C组患儿治愈率大于A组和B组,差异有统计学意义(P<0.0167)。结论低温等离子消融和(或)鼻动力切除均是治疗腺样体肥大的有效手术方式,但鼻动力联合低温等离子术式具有手术时间短、出血少、治愈率高、疗效好等优点,是临床值得推广的一种手术方式。
Objective To compare the efficacy and safety of endoscopic low temperature plasma and/or nasal dynamical adenoidectomy,so as to better guide the selection of clinical surgical methods.Methods 270 children patients with adenoid hypertrophy who underwent surgery in our hospital from Sept 2012 to Jan 2020 were randomly divided into three groups,90 in each group:Group A-nasal dynamical group,adenoids were removed by nasal dynamical method,and compression and electrocoagulation were used to stop bleeding.Group B-plasma group,adenoids were removed by low temperature plasma radiofrequency ablation.Group C-nasal dynamical combined with low temperature plasma group,adenoids were removed by nasal dynamical resection to the fascia surface of pharyngeal skull base about 2mm,and then low temperature plasma were used for radiofrequency ablation hemostasis of the residual adenoid.Results All the children had successful operation and no complications occurred during and after the operation,and most of the children were cured after surgery.However,the operation time of group C was better than group A and group B,group C was superior to group A in bleeding volume,and the OSA-18 score of group C was lower than group A and group B at 6 months after surgery,all with statistically significant difference(P<0.05).The cure rate in group C was higher than group A and B,with statistically significant difference(P<0.0167).Conclusion Low temperature plasma ablation and/or dynamic nasal resection are both effective surgical methods for treating adenoid hypertrophy,but the combination of them has the advantages of short operation time、less bleeding、higher cure rate and good curative effect,which is a surgical method worthy of promotion in clinical practice.
作者
张少华
陈瑾
杨晓琦
李洪跃
徐先发
唐玲
ZHANG Shaohua;CHEN Jin;YANG Xiaoqi;LI Hongyue;XU Xianfa;TANG Ling(Department of Otorhinolaryngology Head and Neck Surgery,Civil Aviation General Hospital,Beijing,100123,China)
出处
《中国中西医结合耳鼻咽喉科杂志》
2021年第3期219-222,240,共5页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
关键词
低温等离子
腺样体肥大
鼻内镜
low temperature plasma
adenoid hypertrophy
nasal endoscope
作者简介
通信作者:唐玲,主任医师.Email:youya-linlin@163.com。
