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

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