儿童扁桃体、腺样体低温等离子切除术后出血的临床研究

Hemorrhage following coblation-assisted tonsillectomy and adenoidectomy in children

目的探讨应用低温等离子手术或者传统手术方式行儿童扁桃体、腺样体切除术在术后出血方面存在的差异。方法回顾性分析1 597例接受手术治疗的儿童慢性扁桃体炎、腺样体肥大的患者资料,行等离子射频辅助的扁桃体和(或)腺样体切除术者793例(等离子组),行传统扁桃体切除和(或)腺样体者804例(传统组)。比较两组原发性及继发性出血的发生率、出血程度和出血部位的差异。结果等离子组发生术后出血25例(3.2%),传统组出血19例(2.4%),两组间差异无统计学意义(χ2=3.34,P>0.05);其中等离子组原发性出血9例(1.1%),继发性出血16例(2.0%);传统组原发性出血11例(1.4%),继发性出血8例(1.0%),两者比较差异有统计学意义(χ2=9.45,P<0.01)。两组术后的出血部位经卡方检验,出血程度经Wilcoxon秩和检验,P值均>0.05,差异均无统计学意义。结论低温等离子辅助行儿童扁桃体、腺样体切除术,在术后出血的发生率、程度、部位三个方面相对于传统的手术方法治疗,二者差异无统计学意义。

Objective To investigate the postoperative bleeding of coblation-assisted and traditional operation in chil- dren＇ s tonsillectomy and/or adenoidectomy. Methods Data of 1597 children with tonsillitis and adenoid hypertrophy, who underwent traditional（ 804 cases） or coblation-assisted （793 cases） operation between January 1,2007 and Decem- ber 30,2011, were reviewed. Incidence of hemorrhage, severity and location between the two groups were compared. Results Postoperative hemorrhage occurred in 25 patients with coblation assisted operation （3.2%） and 19 patients with traditional operation （2.4%） （X2 = 3. 34, P 〉 0.05 ）. There was no difference in the site （g2 = 0. 736, P = 0. 085 ） or incidence （Z = 0. 392, P = 0. 614） . Significant difference was found in the interval of hemorrhage after sur- gery between the two surgical techniques （X2 = 9.45, P 〈 0.01 ）. Conclusion There is no difference in the postopera- tive hemorrhage for coblation-assisted or traditional tonsillectomy and adenoidectomy in children.