微创钨针刀切除会厌囊肿的临床分析

Clinical analysis of treating cyst of epiglottis with micro-dissection needle

目的探讨微创钨针刀治疗会厌囊肿的临床疗效。方法回顾性分析2014年1月 2017年7月我院收治的86例会厌囊肿患者的临床资料,其中15例采用微创钨针刀切除(钨针刀组);50例采用冷器械切除+单极电凝(传统组);21例采用超声刀切除(超声刀组)。对3组患者的手术时间、术中出血量,术后第1、 2、 4天疼痛评分及术后第10、 15、 20天创面恢复情况(创面伪膜消失)等指标进行分析。结果钨针刀组和超声刀组的手术时间、术中出血量均少于传统组(P<0.05)。术后第1天,钨针刀组的疼痛评分(V AS)明显低于超声刀组和传统组(P<0.05);术后第2、4天,钨针刀组VAS评分低于超声刀组(P<0 .05),与传统组差异无统计学意义。术后第10、 15天,钨针刀组创面伪膜消失比例高于超声刀组(P<0 .05),创面恢复良好;术后第20天,3组创面伪膜全部消失。结论使用微创钨针刀切除会厌囊肿具有术中出血少、耗时短,术后疼痛轻、恢复快等优点,值得临床推广。

Objective To investiage the clinical effect of micro-dissection needle in treating cyst of epiglottis. Methods The study included 86 cases received surgical treatment in our hospital from January 2014 to July 2017. Fifteen cases were treated with micro-dissection needle (micro-dissection needle group), 50 cases were treated with cold instruments and monopolar electrocoagulation (traditional group) and 21 cases were treated with ultrasonic scalpel (ultrasonic scalpel group). The therapeutic effects including operation time, intraoperative blood loss, visual analogue scale (VAS) on the 1st, 2nd, 4th day after operation and the recovery of wound surface (pseudomembrane disappearance) on the 10th, 15th, 20th day after operation were compared between the three groups. Results The operation time and intraoperative bleeding were less in micro-dissection needle group and the ultrasonic scalpel group than those of traditional group (P<0 .05). On the 1st day after operation, VAS scores were significantly lower in micro-dissection needle group than those of the ultrasonic scalpel group and the traditional group (P<0.05). On the 2nd and 4th day after operation, VAS scores were significantly lower in micro-dissection needle group than those of the ultrasonic scalpel group (P<0.05), and there was no significant difference between micro-dissection needle group and the traditional group. On the 10th and 15th day after operation, the proportion of pseudomembrane disappearance was significantly higher in micro-dissection needle group than that in the ultrasonic scalpel group (P<0.05), and the wound recovered well. On the 20th day after operation, all the wound pseudomembranes disappeared in the three groups. Conclusion Removal of epiglottis cyst with micro-dissection needle has advantages of less intraoperative blood loss, shorter operation time, less postoperative pain and quicker recovery, and is worthy of clinical promotion.