鼻内镜不同进路下腺样体切除手术的疗效比较分析

Comparision of the Efficacy of Adenoidectomy with Different Nasal Endoscopy Approach

目的比较鼻内镜下经鼻进路和经口进路显像行腺样体切除术两种术式的疗效。方法将78例腺样体肥大患者随机分为0°鼻内镜经鼻显像行腺样体切除术组(经鼻组)37例,70°鼻内镜经口显像行腺样体切除术组(经口组)41例,就两组手术时间、术中出血量、治疗效果、术后并发症发生情况进行分析。结果手术时间:经鼻组(10.14±4.56)min,经口组(7.90±3.95)min,两组比较差异有统计学意义(P<0.05);术中出血量:经鼻组(53.24±30.24)mL,经口组(48.73±31.56)mL,两组差异无统计学意义(P>0.05);治愈率:经鼻组治愈率为89.2%,经口组治愈率为92.7%,两组差异无统计学意义(P>0.05);术后并发症:经鼻组出现了3例鼻粘膜损伤,1例鼻腔粘连,2例悬雍垂或软腭损伤;经口组则无出现上述并发症。结论用70°鼻内镜经口进路显像行腺样体切除术手术时间更少,术后并发症更少,因而更为优胜。

Objective To compare the efficacy of adenoidectomy with different nasal endoscopy approach：trans-nasal or trans-oral.Methods 78 cases with adenoid hypertrophy were randomly divided into trans-nasal group（using 0° nasal endoscopy trans-nasal imaging） and trans-oral group（using 70° nasal endoscopy trans-oral imaging）;The operative time,blood loss,efficacy and complications were analyzed.Results The operative time in trans-nasal group and trans-oral group was（10.14 ± 4.56） min and（7.90 ± 3.95） min respectively,and the difference was statistically significant（P 0.05）.The intraoperatve blood loss in trans-nasal group and trans-oral group was（53.24 ± 30.24） mL and（48.73 ± 31.56） mL respectively,and the difference was not statistically significant（P 0.05）.The cure rate in trans-nasal group and trans-oral group was 89.2% and 92.7% respectively,and the difference was not statistically significant（P 0.05）.There were 3 cases of nasal damage,1 case of nasal adhesion,2 cases of the uvula or soft palate injury in the trans-nasal group,while no above complications were found in the trans-oral group.Conclusions The adenoidectomy with 70° nasal endoscopy trans-oral imaging has the advantages of shorter operative time,fewer postoperative complications,and thus is even better.