低温等离子与常规方法切除扁桃体的临床比较

Coblation-assisted tonsillectomy versus conventional tonsillectomy in clinic

目的:比较低温等离子手术系统切除扁桃体与常规剥离法切除扁桃体两种方法在手术时间、术中及术后出血、术后疼痛、术后伪膜形成等方面的优劣。方法:将64例患者随机分为Coblator组和常规手术组,Coblator组用CoblatorⅡ低温等离子手术系统摘除扁桃体;常规手术组则采用常规手术方法摘除扁桃体。手术均由同一术者完成,记录单侧手术所需时间、术中出血量、术后24 h患者咽部疼痛情况及扁桃体伪膜形成状况。结果:Coblator组手术时间比常规手术组短,术中出血量(3.1±0.9)ml,而常规手术组平均出血量为(20.1±2.0)ml;Coblator组患者术后24 h疼痛轻于常规手术组;术后24 h伪膜形成较均匀,占术区面积百分比高,厚度较常规手术组薄;比常规手术组更早恢复正常饮食。常规手术组有1例患者于术后第4天手术创面有活动性出血,在表面麻醉下双极电凝止血。结论:等离子切除扁桃体与常规方法相比,手术时间缩短,出血量减少,术后疼痛轻,术后术区的伪膜形成均匀,可以更快恢复正常饮食。

Objective Compare coblation-assisted tonsillectomy with conventional tonsillectomy to see if there is any difference in operating time;intraoperative bleeding and postoperative bleeding;postoperative pain,the formation of postope-rative pseudomembrane.Methods 64 patients were randomly divided into coblation-assisted group and the conventional group.The former is with the help of the Coblator II ,the latter is with the routine instruments.The same surgeon operated on them all.The unilateral operating time,bleeding,Postoperative pain and the formation of postoperative pseudomembrane in 24 hours of afteroperation were recorded separately.Results Coblation-assisted tonsillectomy was fast.The average amount of intraop-erative bleeding of Coblation-assisted group was （3.1 ± 0.9）ml,while the convention-nal group was （ 20.1 ±2.0 ） ml.Patients of coblation-assisted group had less pain in 24 hours after operation than in conventional group.Homogeneous formation of postoperative pseudomembrane as found in the coblation-assisted group,but the is pseu-domembrane thinner.Coblation-assisted group ones returned to normal diet earlier than the conventional group.Conclusion Comparing with conventional dissection,Coblation-assisted tonsillectomy is quickly to perform with less intraoperative bleeding,less postoperative pain,more homogeneous pseudomembrane,earlier return to normal diet.