高频电刀对扁桃体组织热损伤的研究

Thermal damage of hypercator on tonsil tissue

目的：观察高频电刀在不同模式及功率下对扁桃体组织的热损伤差异．为临床使用高频电刀开展扁桃体部分切除手术提供参考。方法：90例行双侧扁桃体全切术的儿童，随机分为3组．每组30例．全麻下用传统剥离法将双侧扁桃体分离至下极呈蒂状，圈套器套切离体前左侧用电凝模式、右侧改用电切模式在不同功率下切取2等份，A、B、C组的功率分别为15、20w；25、30w；35、40w。光学显微镜下观察组织变性、坏死、缺损情况．．结果：电凝模式及电切模式均在20～25w的状态下对扁桃体组织的热损伤深度最低．与其他功率下的损伤深度比较差异有统计学意义（P〈0．05）。结论：高频电刀行扁桃体部分切除手术的最佳功率为20～25w，在缺乏器械的单位及基层医院可考虑选用其电凝模式在该功率范围内开展扁桃体部分切除手术．

Objective To observe the thermal damage of hypercator under different modes and different powers on tonsil tissue, and to provide the reference for clinical application of hypercator in partial tonsillectomy operation. Methods 90 children needing bilateral tonsil resection were randomly divided into 3 groups （each n = 30）. Under general anesthesia, bilateral tonsils were stripped to lower pole like a pedicle with traditional stripping method. Before extirpation with snare, the tonsils were resected in 2 equal portions. The left side was under electric coagulation mode and the right side was under electric cut mode, and the power in Group A, B and C were 15 W, 20 W; 25 W, 30 W; 35 W, 40 W; respectively. All the tonsil biopsies were observed under the optical microscope. Results The degree of thermal damage was the lowest when the power was 20 - 25 W in both electric cut mode and electric coagulation mode as compared to those under other power （P 〈 0.05）. Conclusions The optimal power of hypercator in partial tonsillectomy operation was 20 - 25 W under the electric coagulation mode, which could be chosen in the units or primary hospitals lacking of apparatus.