鼻内镜下动力系统腺样体切除+低温等离子止血术治疗腺样体肥大的优势

doi:10.3760/cma.j.issn.1007-1245.2024.22.006

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (22): 3722-3724.DOI: 10.3760/cma.j.issn.1007-1245.2024.22.006

鼻内镜下动力系统腺样体切除+低温等离子止血术治疗腺样体肥大的优势

郑伟畅¹ 罗武锋² 吴子楷¹ 林瑶³

¹揭阳市第三人民医院耳鼻咽喉科，揭阳　522000；²揭阳市人民医院神经外科，揭阳　522000；³揭阳市人民医院口腔科，揭阳　522000

收稿日期:2024-01-26 出版日期:2024-11-15 发布日期:2024-11-13
通讯作者: 郑伟畅，Email：617815085@qq.com
基金资助:
2023年广东省医学科学技术研究基金（A2023272）

Advantages of endoscopic kinetic system adenoidectomy + low temperature plasma hemostasis in the treatment of adenoid hypertrophy

Zheng Weichang¹, Luo Wufeng², Wu Zikai¹, Lin Yao³

¹Department of Otolaryngology, Jieyang Third People's Hospital, Jieyang 522000, China; ²Neurosurgery, Jieyang People's Hospital, Jieyang 522000, China; ³Department of Stomatology, Jieyang People's Hospital, Jieyang 522000, China

Received:2024-01-26 Online:2024-11-15 Published:2024-11-13
Contact: Zheng Weichang, Email: 617815085@qq.com
Supported by:
2023 Guangdong Medical Science and Technology Research Fund (A2023272)

摘要/Abstract

摘要：

目的　探讨经鼻0°鼻内镜下动力系统腺样体切除+低温等离子止血术治疗腺样体肥大的优势。方法　收集2021年4月至2023年4月在揭阳市第三人民医院耳鼻咽喉科行小儿鼾症手术的111例患儿资料，男63例、女48例，年龄2～15岁，病程0.3～6.0年，腺样体中度肥大76例、腺样体重度肥大35例。其中56例采用鼻内镜下动力系统腺样体切除+低温等离子止血术（联合组），55例采用低温等离子腺样体消融术（低温等离子组）。对比两组手术时间、鼻腔恢复正常通气时间、恢复正常活动时间、术后鼻咽部不适感等。采用χ²检验、独立样本t检验。结果　两组患儿手术及预后均良好，随访6个月以上，创面愈合及瘢痕化均正常，症状均完全缓解，无并发症。联合组出血量（2.0±1.0）ml与低温等离子组（2.0±1.0）ml比较，差异无统计学意义（P>0.05）；联合组手术时间、鼻腔恢复正常通气时间均短于低温等离子组［（5.0±1.0）min比（12.0±3.0）min、（3.0±1.0）d比（5.0±1.0）d］，差异均有统计学意义（均P<0.001）；联合组术后鼻咽部不适感比例（2/56）低于低温等离子组（10/55），差异有统计学意义（P<0.05）。结论　与单纯低温等离子腺样体消融术比较，经鼻0°鼻内镜下动力系统腺样体切除+低温等离子止血术，有手术时间更短、术后鼻咽部不适感更轻、术后鼻腔通气恢复更快等优点。

关键词:

儿童, 腺样体肥大, 动力系统切割, 低温等离子射频消融

Abstract:

Objective　To investigate the advantages of transnasal 0° nasal endoscopic adenoidectomy + low-temperature plasma hemostasis in the treatment of adenoid hypertrophy. Methods　The data of 111 children undergoing pediatric snoring surgery were collected from the Department of Otolaryngology, Jieyang Third People's Hospital from April 2021 to April 2023, including 63 boys and 48 girls, aged 2-15 years, with a disease course of 0.3-6.0 years. There were 76 cases with moderate adenoid hypertrophy and 35 cases with severe adenoid hypertrophy. Among them, 56 patients underwent endoscopic kinetic system adenoidectomy + low temperature plasma hemostasis (combined group), and 55 patients underwent low temperature plasma adenoidectomy (low temperature plasma group). The operation time, nasal normal ventilation time, normal activity time, and postoperative nasopharyngeal discomfort were compared between the two groups. χ² test and independent sample t test were used. Results　The operation and prognosis of the two groups were good. After more than 6 months of follow-up, the wound healing and scarring were normal, and the symptoms were completely relieved without complications. There was no statistically significant difference in the blood loss between the combined group [(2.0±1.0) ml] and the low temperature plasma group [(2.0±1.0) ml] (P>0.05). The operation time and nasal normal ventilation time in the combined group were shorter than those in the low-temperature plasma group [(5.0±1.0) min vs. (12.0±3.0) min, (3.0±1.0) d vs. (5.0±1.0) d], with statistically significant differences (both P<0.001). The rate of postoperative nasopharyngeal discomfort in the combined group (2/56) was lower than that in the low-temperature plasma group (10/55), with a statistically significant difference (P<0.05). Conclusion　Compared with simple low temperature plasma adenoidectomy, transnasal 0° nasal endoscopic dynamic system adenoidectomy + low temperature plasma hemostasis has the advantages of shorter operation time, less postoperative nasopharyngeal discomfort, and faster recovery of postoperative nasal ventilation.

Key words:

Children, Adenoid hypertrophy, Kinetic system cleavage, Low-temperature plasma radiofrequency ablation

郑伟畅罗武锋吴子楷林瑶.

鼻内镜下动力系统腺样体切除+低温等离子止血术治疗腺样体肥大的优势 [J]. 国际医药卫生导报, 2024, 30(22): 3722-3724.

Zheng Weichang, Luo Wufeng, Wu Zikai, Lin Yao.

Advantages of endoscopic kinetic system adenoidectomy + low temperature plasma hemostasis in the treatment of adenoid hypertrophy [J]. International Medicine and Health Guidance News, 2024, 30(22): 3722-3724.

参考文献

[1] 黄健聪,杨钦泰,张革化,等.内镜下儿童腺样体切除3种不同术式的疗效和优越性评价[J].中国内镜杂志,2009,15(7):700-703.
[2] 叶刚,周林路,刘世喜,等.国产低温等离子治疗儿童腺样体肥大的临床价值[J].西部医学,2015,27(11):1680-1682,1685. DOI:10.3969/j.issn.1672-3511.2015.11.023.
[3] 陈文龙,杜志宏.鼻内镜下低温等离子射频消融术治疗儿童扁桃体及腺样体肥大的效果评价[J/CD].现代医学与健康研究(电子版),2024,8(7):142-144. DOI:10.3969/j.issn.2096-3718.2024.07.043.
[4] 罗勇.鼻内镜辅助下低温等离子消融与电动吸切器治疗腺样体肥大的临床效果观察[J].中国医药指南,2020,18(10):137-138. DOI:10.15912/j.cnki.gocm.2020.10.063.
[5] 崔颖,谷京城,王雪峰,等.鼻内窥镜下儿童腺样体吸割术探讨[J].中国内镜杂志,2005,11(6):590-591,594. DOI:10.3969/j.issn.1007-1989.2005.06.011.
[6] 刘贤,李鹏,叶进,等.鼻内镜双径路吸割术治疗腺样体肥大[J].中国内镜杂志,2006,12(1):40-41,45. DOI:10.3969/j.issn.1007-1989.2006.01.014.
[7] 陈钢,吴慧莉,孙汝山,等.经鼻和口进路腺样体切除术出血分析[J].临床耳鼻咽喉头颈外科杂志,2009,23(14):652-654. DOI:10.3969/j.issn.1001-1781.2009.14.010.
[8] 张佐.OSAHS基础知识和新进展[M].银川:阳光出版社,2020.
[9] 何权瀛,陈宝元,韩芳.睡眠呼吸病学[M].2版.北京:人民卫生出版社,2022.
[10] 鲜军舫,李书玲.同仁鼻咽喉影像学[M].北京:人民卫生出版社,2022.
[11] 冼志雄,李兰,梁振江.鼻咽侧位片与电子鼻咽镜诊断儿童腺样体肥大价值的比较[J].临床耳鼻咽喉头颈外科杂志,2007,21(21):996-998. DOI:10.3969/j.issn.1001-1781. 2007.21.013.
[12] 叶暴著.内镜下低温等离子腺样体消融术联合鼓室置管术治疗分泌性中耳炎伴腺样体肥大患儿的效果[J].中国民康医学,2024,36(12):55-58. DOI:10.3969/j.issn.1672-0369. 2024.12.017.
[13] 陈进.腺样体肥大患儿术后生活质量调查及其影响因素分析[J/CD].现代医学与健康研究(电子版),2024,8(15):21-23. DOI:10.3969/j.issn.2096-3718.2024.15.007.
[14] 龙朝庆,颜永毅,容庆丰.OSA-18量表评估腺样体肥大儿童生活质量[J].山东大学耳鼻喉眼学报,2015,29(3):13-15,19.
[15] 叶远航,冯艳萍.儿童阻塞性睡眠呼吸暂停低通气综合征手术前后生活质量调查[J].中外医学研究,2013,11(12):19-20. DOI:10.3969/j.issn.1674-6805.2013.12.014.
[16] 吴海导.不同术式治疗腺样体肥大的临床效果及安全性分析[J].中国现代药物应用,2024,18(14):51-53. DOI:10.14164/j.cnki.cn11-5581/r.2024.14.012.
[17] 胡文良,孙娟,李玲香,等.不同视野鼻内镜下腺样体切除术的疗效分析及体会[J].中国耳鼻咽喉颅底外科杂志,2011,17(1):70-71.
[18] 陈畅,赵玲,杨莹,等.微创技术在咽喉部手术中的应用及展望[J].中国疗养医学,2024,33(10):63-67. DOI:10.13517/j.cnki.ccm.2024.10.013.
[19] 郑峰,林潮楷,洪树鹏,等.低温等离子消融术与传统手术治疗儿童腺样体肥大的临床效果对比[J].基层医学论坛,2023,27(23):1-3. DOI:10.19435/j.1672-1721.2023. 23.001.
[20] 刘冰,王德霖.扁桃体腺样体肥大患儿使用低温等离子扁桃体腺样体切除术进行治疗的临床效果[J].中国医学文摘(耳鼻咽喉科学),2023,38(5):17-20. DOI:10.19617/j.issn1001-1307.2023.05.17.

鼻内镜下动力系统腺样体切除+低温等离子止血术治疗腺样体肥大的优势

Advantages of endoscopic kinetic system adenoidectomy + low temperature plasma hemostasis in the treatment of adenoid hypertrophy

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