CAJ | 학술논문

目的通过与常规扁桃体剥离术比较,探讨超声刀辅助扁桃体切除术的优缺点.方法 88例成人扁桃体切除适应证患者分为超声刀组(42例)和对照组(46例).超声刀组通过超声刀行扁桃体切除术,对照组则采用常规扁桃体剥离术.记录完整切除扁桃体所用的时间和术中出血量、术后咽痛等情况.结果超声刀组平均((x-)±s,下同)手术时间(14.7 ±4.0) min比对照组(28.9 ±.7.6)min短,术中出血量(3.1±1.1)ml较对照组(19.0 ± 5.2) ml少,差异均具有统计学意义(t值分别为-10.691和-19.544,P值均＜0.05).超声刀组术后当天10 h内疼痛轻于对照组,但术后3d后咽痛较对照组明显,多数患者持续时间较长(秩和检验P值均＜0.05).常规剥离法扁桃体白膜脱落平均时间为术后8d,而超声刀组平均为11d,两者比较差异有统计学意义(t=5.115,P＜0.05).结论超声刀扁桃体切除术具有手术时间短、术中出血量少等优点,但术后咽痛症状存留时间较长,且白膜脱落时间迟,需避免饮食不当造成继发性出血.
목적 통과여상규편도체박리술비교,탐토초성도보조편도체절제술적우결점.방법 88례성인편도체절제괄응증환자분위초성도조(42례)화대조조(46례).초성도조통과초성도행편도체절제술,대조조칙채용상규편도체박리술.기록완정절제편도체소용적시간화술중출혈량、술후인통등정황.결과 초성도조평균((x-)±s,하동)수술시간(14.7 ±4.0) min비대조조(28.9 ±.7.6)min단,술중출혈량(3.1±1.1)ml교대조조(19.0 ± 5.2) ml소,차이균구유통계학의의(t치분별위-10.691화-19.544,P치균＜0.05).초성도조술후당천10 h내동통경우대조조,단술후3d후인통교대조조명현,다수환자지속시간교장(질화검험P치균＜0.05).상규박리법편도체백막탈락평균시간위술후8d,이초성도조평균위11d,량자비교차이유통계학의의(t=5.115,P＜0.05).결론 초성도편도체절제술구유수술시간단、술중출혈량소등우점,단술후인통증상존류시간교장,차백막탈락시간지,수피면음식불당조성계발성출혈.
Objective To investigate the advantages and disadvantages of ultracision-harmonic scalpel assisted tonsillectomy by compared with conventional tonsillectomy.Methods Eighty-eight patients were randomly divided into ultrasonic scalpel group (group A,42 cases) and control group (group B,46 cases).The tonsillectomy in group A was performed with ultracision-harmonic scalpel,and in group B,the tonsillectomy was performed by routine method.The surgical time (complete removal of tonsils),blood loss,and postoperative sore throat situation were recorded.Results Surgical time in group A [( 14.7 ± 4.0 )min] was shorter than that in group B [(28.9 ±7.6) min],t =- 10.691,P ＜0.05.Blood loss in group A [(3.1 ±1.1) ml] was less than that in group B[(19.0 ±5.2) ml],t =- 19.544,P＜0.05.Postoperative sore throat was less painful in group A than that in group B in 10 hours after surgery,but much painful than group B 3 days after surgery and most patients lasted longer.There were statistical differences (P ＜ 0.05 ).The average peel off time for the tunica albuginea was 8 days after the operation by using traditional method,by compared with the ultrasonic scalpel method,average time was 11 days,the difference showed statistical significance (t =5.115,P ＜ 0.05).Conclusions Compared with traditional tonsillectomy,ultracision-harmonic scalpel tonsillectomy had shorter operative time,less blood loss and so on,but the sore throat symptoms persisted longer.In addition,the tunica albuginea peeled off later,so avoidance of secondary bleeding caused by improper diet was mandatory.