低温等离子刀对小儿扁桃体和腺样体切除的应用价值

THE VALUE OF LOW TEMPERATURE-CONTROLLED PLASMA RADIO-FREQUENCY ABLATION IN EXCISION OF TONSIL AND ADENOID IN CHILDREN

目的探讨低温等离子刀在小儿扁桃体、腺样体切除中的应用价值。方法回顾性分析2012年9月—2013年2月在我科住院行扁桃体、腺样体切除的病儿234例,分为低温等离子组138例,常规组96例。低温等离子组采用低温等离子刀手术切除扁桃体、腺样体。常规组采用扁桃体剥离术及腺样体刮除术进行治疗。对两组病儿的手术时间(从手术开始至充分止血为止)、术中与术后出血量、术后疼痛分级、术后切口周围软组织水肿程度等进行对比分析。结果低温等离子组病儿手术时间、术中出血量、术后疼痛评分与常规组比较差异具有显著性(t=22.57,t′=48.32、18.09,P<0.05),两组术后出血情况比较差异无显著性(P>0.05)。结论低温等离子刀切除小儿扁桃体、腺样体术中出血少,术后病儿疼痛轻,且手术时间短、操作简便,有较高的临床应用价值。

Objective To assess the value of temperature-controlled radio-frequency for tonsillectomy and adenoidectomy in children. Methods A retrospective review was done in 234patients who underwent tonsillectomy and adenoidectomy in our department during September 2012—February 2013,of whom,138were assigned to temperature-controlled（T-C）group and 96to routine group.The operation in the T-C group was done using radio-frequency,and the operation in the routine group was performed using tonsillectomy by dissection and curettage of adenoids.A comparison between the two groups was conducted in regard to the following items：operation time,blood loss at surgery and after,post-operative pain grading and postoperative edema of surrounding soft tissue of the incision. Results The differences between the two groups were significant in terms of operation time, blood loss at surgery,and post-operative pain grading（t=22.57;t′=48.32,18.09;P0.05）,but no statistical difference was observed in regard to postoperative hemorrhage（P0.05）. Conclusion Temperature-controlled radiofrequency is of higher value in clinical application to ablate tonsils and adenoids in children because of less bleeding at surgery,less pain after surgery,short operation time and convenient to perform.