CAJ | 학술논문

目的:比较低温等离子扁桃体消融术与常规扁桃体剥离术对患儿术中、术后的影响.方法:92例患儿,随机分为等离子组和对照组,等离子组用低温等离子射频消融系统连接EVac 70 T&A 刀头,能量设置为7,消融扁桃体;对照组则采用常规扁桃体剥离术,分别记录2种方法所需时间和出血量;使用Wong-Baker FACES疼痛评分表记录术后第1天至第10天患儿每日咽部疼痛情况,恢复正常饮食和正常活动时间;记录术后并发症.结果:等离子组手术时间比对照组短(分别为10.2 min和36.5 min,P<0.01),等离子组术中平均出血量为(6.83±3.36)ml,而对照组为(30.07±7.04)ml;等离子组患儿术后第1、2、3天疼痛轻于对照组,第4～10天两组差异无统计学意义;等离子组比对照组更早恢复正常饮食,但恢复正常活动时间相似.对照组有1例患儿于术后第6天口咽部有活动性出血,需缝扎止血.结论:低温等离子扁桃体消融术与常规扁桃体剥离术相比,手术时间缩短,出血量极少,手术方法容易掌握,恢复正常饮食时间早,术后前3天疼痛较轻.
목적:비교저온등리자편도체소융술여상규편도체박리술대환인술중、술후적영향.방법:92례환인,수궤분위등리자조화대조조,등리자조용저온등리자사빈소융계통련접EVac 70 T&A 도두,능량설치위7,소융편도체;대조조칙채용상규편도체박리술,분별기록2충방법소수시간화출혈량;사용Wong-Baker FACES동통평분표기록술후제1천지제10천환인매일인부동통정황,회복정상음식화정상활동시간;기록술후병발증.결과:등리자조수술시간비대조조단(분별위10.2 min화36.5 min,P<0.01),등리자조술중평균출혈량위(6.83±3.36)ml,이대조조위(30.07±7.04)ml;등리자조환인술후제1、2、3천동통경우대조조,제4～10천량조차이무통계학의의;등리자조비대조조경조회복정상음식,단회복정상활동시간상사.대조조유1례환인우술후제6천구인부유활동성출혈,수봉찰지혈.결론:저온등리자편도체소융술여상규편도체박리술상비,수술시간축단,출혈량겁소,수술방법용역장악,회복정상음식시간조,술후전3천동통교경.
Objective:To compare low temperature coblation assisted tonsillectomy with conventional dissec-tion tonsillectomy intraoperation and afteroperation. Method:Ninty-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocare EVac 70 T&.A Wand was used for cobla-tion-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded seperately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of afteroperation. Result: Coblation assisted group had a shorter operative time than the control group (10. 2min vs. 36. 5min, P<0. 001). The average amount of intraoperative bleeding of Coblation assisted group was(6. 83±3. 36) ml, while the control group was(30. 07±7. 04)ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group, who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. Conclusion: Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding,shorter operation time,earlier return to normal diet, less pain on 1st to 3th day postoperatively.