全程双极儿童扁桃体切除术在欠发达地区医院的临床应用

Clinical Application of Whole-course Bipolar Electrocoagulation Tonsillectomy for Children in Hospitals in Underdeveloped Areas

目的:探究全程双极儿童扁桃体切除术在欠发达地区医院的临床应用。方法:选取2018年1-11月于本院行扁桃体切除术的63例患儿为研究对象。根据不同的扁桃体切除手术方式随机分为对照组35例和观察组28例,对照组采用低温等离子切除术,观察组采用双极电凝切除术。比较两组的手术时间、术中出血量、术后白膜脱落时间、术后疼痛评分、住院时间及住院费用。结果:两组患儿均顺利完成手术,且术后均无严重并发症发生。观察组手术时间长于对照组,住院费用明显低于对照组,差异均有统计学意义(P<0.05);两组的出血量、白膜脱落时间及住院时间比较,差异均无统计学意义(P>0.05)。两组术前及术后的VDS、VAS评分比较,差异均无统计学意义(P>0.05)。观察组并发症发生率为3.57%,与对照组的2.86%比较,差异无统计学意义(P>0.05)。结论:双极电凝的术中出血量、术后疼痛程度、白膜脱落时间、住院时间及术后并发症等指标与等离子切除术比较无明显差异,但采用双极电凝切除扁桃体患儿住院费用较低温等离子术明显降低,值得在欠发达地区医院进行临床推广应用。

Objective:To explore the clinical application of whole-course bipolar electrocoagulation tonsillectomy for children in hospitals in underdeveloped areas.Method:Sixty-three children who underwent tonsillectomy in our hospital from January to November 2018 were selected as study subjects.According to different tonsillectomy methods,they were randomly divided into control group 35 cases and observation group 28 cases.The control group was treated with low temperature plasma resection,and the observation group was treated with bipolar electrocoagulation.The operation time,intraoperative blood loss,postoperative leucorrhea shedding time,postoperative pain score,hospitalization time and hospitalization expenses were compared between the two groups.Result:Two groups of children were successfully completed the operation,and no serious complications occurred.The operation time of the observation group was longer than that of the control group,and the hospitalization cost was significantly lower than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the amount of bleeding,the time of leucorrhea shedding and the length of hospital stay between the two groups(P>0.05).There were no significant differences in the scores of VDS and VAS between the two groups before and after operation(P>0.05).The incidence of complications in the observation group was 3.57%,compared with 2.86%in the control group,the difference was not statistically significant(P>0.05).Conclusion:There are no significant differences in blood loss,postoperative pain,leucorrhea shedding time,hospitalization time and postoperative complications between bipolar electrocoagulation and plasma resection,but the hospitalization cost of tonsillectomy with bipolar electrocoagulation was significantly lower than that of lowtemperature plasma,which was worthy of clinical application in hospitals in underdeveloped areas.