超声刀在鼻咽喉-头颈外科手术中的应用价值

Application of ultrasonic activated shears in otolaryngology-head and neck surgeries

目的评价超声刀在鼻咽喉-头颈外科手术中的应用价值。方法第二军医大学附属长征医院鼻咽喉-头颈外科分别应用超声刀及传统电刀对256例患者进行手术,超声刀组130例中,行悬雍垂腭咽成形术24例、扁桃体切除术22例、鼻甲切除术26例、鼻咽纤维血管瘤切除术2例、甲状腺切除术32例、颈淋巴结清扫术24例;传统电刀组126例中,行悬雍垂腭咽成形术26例、扁桃体切除术27例、鼻甲切除术26例、鼻咽纤维血管瘤切除术1例、甲状腺切除术30例、颈淋巴结清扫术16例。比较两组的手术时间、术中出血量、术后引流量、并发症情况及术后住院时间。结果超声刀组不同类型手术的手术时间及术后住院时间均显著短于传统电刀组的同类型手术(P值均<0.01),超声刀组甲状腺切除术及颈淋巴结清扫术的术后引流量均显著少于传统电刀组的同类型手术(P值均<0.01),超声刀组不同类型手术的术中出血量均显著少于传统电刀组的同类型手术(P值均<0.01)。两组患者术后均痊愈出院,无1例患者出现并发症。结论超声刀具有创伤小、术中出血少、手术时间短、术后渗出少及术后痊愈快的优点,值得在鼻咽喉-头颈外科手术中推广应用。

Objective To evaluate the value of ultrasonic activated shears （UAS） in otolaryngology-head and neck surgeries. Methods The clinical data of 256 patients undergoing otolaryngology-head and neck surgeries were retrospectively analyzed. The patients were divided into two groups.. UAS group and traditional group. UAS group included 130 patients（24 Uvulopalatopharyngoplasty [UPPP], 22 tonsil dissection,26 turbinates resection, 2 angiofibroma of nasopharynx resection, 32 thyroidectomy, and 24 radical neck dissection）. The traditional group included 126 patients （26 UPPP, 27 tonsil dissection,26 turbinates resection, 1 angiofibroma of nasopharynx, 30 thyroidectomy, and 16 radical neck dissection）. The total operation time, intraoperative blood loss,postoperative drainage volume, surgical complications and the length of stay after surgery were compared between the two groups for the same surgical procedures. Results No surgical complications were found in the two groups and all the patients were fully recovered. The average operation time and the length of stay after surgery were significantly shorter in the UAS group compared with those for the same surgical procedure in traditional group （all P〈0.01）. The intraoperative blood loss and the postoperative drainage volume of the UAS group were significantly less than those of the same surgical procedure in the traditional group （all P〈0.01）. Conclusion UAS has the advantages of little trauma, less blood loss, less postoperative drainage and shorter operation time, which makes it a choice for otolaryngology-head and neck surgeries.