低温等离子刀与传统术式治疗慢性扁桃体炎的疗效比较

Comparison of efficacy between cryogenic plasma knife and traditional operation on chronic tonsillitis

目的对比分析低温等离子刀与传统术式治疗慢性扁桃体炎的临床疗效。方法选择75例慢性扁桃体炎患者作为研究对象,采用随机数字表法将其分为观察组(38例)及对照组(37例),其中对照组患者接受传统术式切除扁桃体,观察组患者接受低温等离子刀切除扁桃体。比较两组手术时间、术中出血量、术区疼痛评分、术后伪膜完全形成时间,以及两组手术前后的T淋巴细胞亚群、应激指标[还原型谷胱甘肽(G-SH)、超氧化物歧化酶(SOD)]水平和围术期并发症情况。结果观察组手术时间、术后伪膜完全形成时间短于对照组,术中出血量少于对照组,术后术区疼痛评分低于对照组,差异均有统计学意义(均P<0.05)。术后7 d,两组CD3^(+)、CD4^(+)T淋巴细胞水平及CD4^(+)/CD8^(+)比值均高于术前,且观察组高于对照组;两组CD8^(+)T淋巴细胞水平均低于术前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。术后24 h,两组的SOD水平及对照组的G-SH水平高于术前;观察组的G-SH、SOD水平均低于对照组,差异均有统计学意义(均P<0.05)。观察组并发症发生率为2.63%(1/38),明显低于对照组的21.62%(8/37),差异有统计学意义(P<0.05)。结论低温等离子刀治疗慢性扁桃体炎可缩短手术时间,减少术中出血量,更利于机体免疫功能的恢复,降低围术期患者应激反应程度及并发症发生率。

Objective To compare and analyze the clinical efficacy of cryogenic plasma knife and traditional operation on chronic tonsillitis.Methods A total of 75 patients with chronic tonsillitis were selected as the research objects,and they were divided into an observation group(n=38)and a control group(n=37)by the random number table method.The patients in the control group were treated with traditional tonsillectomy,while patients in the observation group were treated with tonsillectomy with cryogenic plasma knife.The operation time,intraoperative blood loss,pain score in the operation area and postoperative pseudomembrane formation time were compared between the two groups,as well as the pre-and post-operative T lymphocyte subsets,and stress indicators(reduced glutathione[G-SH],superoxide dismutase[SOD])levels and perioperative complications.Results As compared with the control group,the observation group had shorter operation time and postoperative pseudomembrane formation time,less intraoperative blood loss and lower postoperative pain score in the operation area,with statistically significant differences(all P<0.05).Seven days after operation,the levels of CD3^(+),CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)ratio in both groups were higher than those before operation,and those were higher in the observation group than in the control group;the level of CD8^(+)T lymphocyte in the two groups were lower than those before operation,which was lower in the observation group than in the control group,with statistically significant differences(all P<0.05).Twenty-four hours after operation,the SOD level in the two groups and the G-SH level in the control group were higher than those before operation;the levels of G-SH and SOD in the observation group were lower than those in the control group,with statistically significant differences(all P<0.05).The incidence of complications in the observation group was 2.63%(1/38),which was significantly lower than 21.62%(8/37)in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of chronic tonsillitis with cryogenic plasma knife can shorten the operation time,reduce the intraoperative blood loss,which is more conducive to the recovery of immune function,and reduce the degree of stress response and the incidence of complications in perioperative patients.