等离子射频消融在鼻咽疾病手术中的应用进展

Application progress of plasma radiofrequency ablation in nasopharyngeal surgery

等离子射频消融术是一种微创手术,用于鼻咽疾病手术中的优势较明显,包括疼痛少、出血量少、术后感染少等,且操作简单,视野清晰。其原理是100 kHz等离子射频电场的条件下,充分形成100μm的等离子体薄层,在射频刀头与组织之间的电解液转换成低温等离子态的情况下,以分子为单位,将靶组织里面的微细胞分解为氧化物以及碳水化合物,从而消融组织或者使其凝固以达到坏死的效果。鼻咽疾病是临床较常见的疾病,包括鼻咽癌、喉乳头状瘤、鼻腔出血等。鼻咽疾病发生机制较复杂,与日常生活习惯、炎症感染、恶性肿瘤形成有关。本文对等离子射频消融在鼻咽疾病手术中的应用进展进行综述,明确了等离子射频消融术原理、治疗条件和环境,总结了等离子射频消融术用于鼻咽疾病手术中的作用,包括减少肿瘤复发、疼痛、出血量、保留正常组织等。但等离子射频消融术在治疗时也应注意一些事项,包括需要精细操作手术、严格执行其适应证和禁忌证,以及鼻咽疾病手术配合时要选择合适时机和能量标准等。

Plasma radiofrequency ablation is a kind of minimally invasive surgery,which has obvious advantages in the operation of nasopharyngeal diseases,including less pain,less blood loss,less postoperative infection,and so on,with simple operation and clear vision.The principle is that under the condition of 100 kHz plasma radiofre quency electric field,a 100μm plasma thin layer is fully formed.When the electrolyte between the radiofre quency knife head and the tissue is converted into a low-temperature plasma state,the micro cells in the target tissue are decomposed into oxides and carbohydrates in molecular units,so as to ablate the tissue or coagulate it,and then achieve the effect of necrosis.Nasopharyngeal disease is a common clinical disease,including nasopharyngeal carcinoma,laryngeal papilloma,epistaxis and so on.The pathogenesis of nasopharyngeal diseases is complex,which is related to daily living habits,inflammation and infection,and the formation of malignant tumor.In this paper,the progress of plasma radiofrequency ablation in the surgery of nasopharyngeal diseases is reviewed.The principle,treatment conditions and environment of plasma radiofrequency ablation are clarified.The role of plasma radiofrequency ablation in the surgery of nasopharyngeal diseases is summarized,including reducing tumor recurrence,pain,bleeding volume,and preserving normal tissue.However,there are some matters needing attention in the treatment of plasma radiofrequency ablation,including the need for fine operation,strict indications and contraindications,and the selection of appropriate timing and energy standard when cooperating with the operation of nasopharyngeal diseases.