鼻内窥镜下腺样体切除58例临床分析

Endoscopic adenoidectomy by nasal endoscopy:A clinical analysis of 58 cases

目的观察鼻内窥镜下腺样体切除术治疗腺样体肥大的临床疗效及安全性。方法选取我院2009年3月～2012年8月收治的110例腺样体肥大患儿作为研究对象,按照随机数字表法随机分为治疗组58例与对照组52例,分别给予鼻内窥镜下腺样体切除术治疗和药物保守治疗,比较两组患儿的临床疗效及不良反应情况。结果治疗后治疗组总有效率明显高于对照组(x2=11.053,P<0.01)。随访6个月比较两组患者复发情况,结果治疗组复发1例,复发率为1.7%;对照组复发5例,复发率为8.6%。对照组复发率明显高于治疗组(x2=5.274,P<0.05)。治疗组术后鼻腔出血2例,给予鼻内0.5%麻黄碱或0.05%盐酸羟甲唑啉滴鼻后停止;对照组出现鼻腔干燥4例,未见其他不良反应。结论鼻内窥镜下腺样体切除术治疗小儿腺样体肥大安全有效,值得推广应用。

Objective To observe the clinical efficacy and safety in the treatment of adenoidal hypertrophy by adenoid adenoidectomy. Methods Selected 110 cases of children with adenoidal hypertrophy as research subjects in our hospital from March 2009 to August 2012,they were randomly divided into treatment group （58 cases） treated with intranasal adenoidectomy under endoscope therapy and control group given conservative treatment （52 cases） according to the random number table, the clinical efficacy and adverse reactions were compared between the two groups. Results After treatment,the total effective rate in treatment group was significantly higher than that in control group （χ^2=11.053,P 〈 0.01）. The recurrence was compared between the two groups during six months of follow-up,1 case relapsed in treatment group, the recurrence rate was 1.7%;5 eases of recurrence in control group, the recurrence rate was 8.6%, the recurrence rate in treatment group was significantly higher than that in control group （χ^2=5.274, P 〈 0.05）.2 cases of nasal bleeding in treatment group after operation, given 0.5% nasal ephedrine or 0.05% hydrochloric acid hydroxyl methyl thiazole moiety to stop bleeding after nasal drops; 4 cases of nasal dryness in control group without other adverse reactions. Conclusion Endoscopic adenoidectomy in the treatment of children with adenoidal hypertrophy is safe and effective,should be widely applied.