等离子扁桃体包膜内切除术治疗儿童睡眠呼吸暂停综合征的效果观察

目的比较等离子扁桃体包膜内切除术与等离子扁桃体包膜外切除术的术后情况。方法选取2018年6月至2020年6月因扁桃体及腺样体肥大行扁桃体伴腺样体切除术患者,观察术后疼痛、咽部水肿情况、有无原发性及继发性出血、白膜脱落时间等。结果术后16 h、20 h、24 h,包膜内切除组疼痛VAS评分低于包膜外切除术,包膜内切除组术后水肿范围小于包膜外切除组。包膜内切除组术后24 h白膜覆盖范围小于包膜外切除组。术后5 d两组白膜均未脱落;术后10 d、15 d、20 d包膜内切除组白膜脱落时间早于包膜外切除组。结论等离子扁桃体包膜内切除术比包膜外切除可以减轻术后疼痛,其优势在术后16 h开始明显体现,同时减少术后软腭、悬雍垂的水肿,缩小手术损伤范围,缩短患者的住院时间,缩短白膜脱落时间,可以使创面早日恢复。

Objective To compare the different postoperative reactions and recovery between plasma sub tonsillectomy with preservation of semilunar fold and traditional plasma tonsillectomy.Methods The patients who underwent tonsillectomy with adenoidectomy in the Department of Otorhinolaryngology of the Third Affiliated Hospital of Wenzhou Medical University from June 2018 to June 2020 due to tonsil and adenoid hypertrophy were selected to observe the postoperative pain,pharyngeal edema,primary and secondary bleeding,and the time of white film falling off.Results In the comparison of visual analogue scale(VAS)scores at 16 hours,20 hours and 24 hours after the operation,the pain score of the experimental group was lower than that of the traditional plasma group,and the postoperative edema range of the experimental group was lower than that of the traditional plasma group.The coverage of white film 24 hours after operation in the experimental group was less than that in the traditional plasma group.The white membrane did not fall off in both groups 5 days after operation.The statistics of white film falling off at 10,15 and 20 days after the operation showed that the falling off time in the half moon fold preserving group was earlier than that in the traditional plasma group.Conclusion Plasma sub tonsillectomy with preserved semilunar fold can reduce postoperative pain compared with traditional plasma tonsillectomy.Its advantages begin to be obvious 16 hours after operation.At the same time,it reduces the edema of soft palate and uvula,reduces the scope of surgical injury,shortens the hospitalization time of patients,shortens the falling time of white membrane,and can make the wound recover as soon as possible.