低温等离子刀与传统剥切方式行扁桃体切除术的治疗效果对比研究

Comparative study of tonsillectomy with cryogenic plasma knife and traditional stripping method

目的对比观察低温等离子刀与传统剥切方式行扁桃体切除术的治疗效果。方法回顾性分析2013年12月～2017年12月期间144例于我院行扁桃体切除术的患者的临床资料,按照手术方法分为观察组(70例,行低温等离子扁桃体切除术)和对照组(74例,行扁桃体传统剥切术)。对比观察两组患者手术指标(手术时间和术中出血量);采用视觉模拟评分法(VAS)对患者术后1、3、7d咽部疼痛程度进行评估;于术后24h评估患者咽部水肿情况;同时记录并对比两组患者术后伤口出血情况。结果观察组手术时间明显短于对照组,术中出血量明显少于对照组,术后24h咽部水肿评分明显低于对照组,差异均具有统计学意义(P <0.05)。术后1、3、7d,观察组患者咽部VAS评分均分别低于对照组,差异均具有统计学意义(P <0.05)。观察组患者术后伤口出血率与对照组相近(2.86%vs 4.05%),差异无统计学意义(P> 0.05)。结论相比于传统剖剥切方式,低温等离子扁桃体切除术能够明显缩短患者手术时间,减少术中出血量,降低患者术后早期咽部疼痛感,有助于患者术后恢复,临床应用价值较高。

Objective To compare the effect of tonsillectomy with low temperature plasma knife and traditional tonsillectomy. Methods The clinical data of 144 tonsillectomy patients in our hospital from December 2013 to December 2017 were analyzed retrospectively. According to the operation method, they were divided into observation group （70 cases, low temperature plasma tonsillectomy） and control group （74 cases, traditional tonsillectomy）. The operative index （operative time and intraoperafive blood loss） were compared between the two groups. Visual analogue scale （VAS） was used to evaluate the degree of pharyngeal pain at 1, 3, and 7 days after surgery, and the pharyngeal edema was evalualed 24 hours after surgery. Meanwhile, the wound bleeding after operation was recorded and compared between the two groups. Results The operation time of the observation group was shorter than thai of the control group, and the amount of bleeding during operation was less than that of the control group. The score of pharyngeal edema 24 hours after operation was lower than thai of the control group, and the difference was statistically significant （P〈 0.05）. The VAS scores of pharynx in the observation group were lower than those in the control group al 1, 3 and 7 days after operation, and the difference was statistically significant （P 〈 0.05）. The postoperative wound bleeding rate of the observation group was similar to that of the control group （2.86% vs 4.05%）, with no significant difference （P〉 0.05）. Conclusion Compared with traditional tonsillectomy, hypothermie plasma tonsillectomy can significantly shorten the operation time, reduce the amount of bleeding, reduce the early postoperative pharyngeal pain, and is helpful to the postoperative recovery of patients with high clinical value.