“电挤切刀”在儿童扁桃体挤切手术中的应用分析

Application of electricity dissectible knife in tonsillectomy in children patients

关键词:  扁桃体切除术  电挤切刀  挤切刀  儿童

Key words:  tonsillectomy  electricity dissectible knife  guillotine  children

摘要:

[目的]探讨“电挤切刀”在儿童扁桃体挤切术中的临床应用效果。[方法]符合扁桃体切除手术指征并符合入选标准的患儿共49例，随机分为实验组和对照组：实验组28例，手术使用“电挤切刀”；对照组21例，手术使用常规挤切刀。对两组手术历时、术中出血量、术后创面反应程度及术后再出血等4项指标进行对比分析。[结果]手术历时：实验组为(3.15±1.30)min，对照组为 (15.30±2.03)min，差异具有显著性意义（P=0.000） ；术中出血量：实验组为(2.54±2.43) mL，对照组为(7.98±3.07) mL，差异具有显著性意义（P=0.000）；术后第1天和第3天创面反应程度：实验组均以轻度为主，对照组以中度为主，轻度反应差异均有显著性意义（P=0.047, P=0.000），中度反应差异也有显著性意义（P=0.047, P=0.000），两组均无呈现重度反应者或术后再出血病例。[结论]使用“电挤切刀”行扁桃体挤切术，扁桃体切除与止血同步完成，操作简便、快捷，副损伤小，安全性较高且具有较好的社会经济效益。

Abstract:

[Objective] To explore the usage of electricity dissectible knife in tonsillectomy in child patients. [Methods] Forty-nine cases of children, 33 male and 16 females hospitalized for tonsillectomy from April 2009 to March 2011 were enrolled in the study. They were divided into experimental, 28 cases and control, 21 cases groups randomly. Tonsillectomy surgeries were performed by using the electricity dissectible knife in experimental group and conventional guillotine in control group. Four indicators, including the duration of tonsillectomy, blood loss volume, postoperative wound reaction and postoperative bleeding events, were recorded during and after the operations. [Results] The duration of tonsillectomy was (3.15±1.30) min in the experimental group and (15.30±2.03) min in the control group (P=0.000). Blood loss volume in the experimental group was (2.54±2.43) mL, while (7.98±3.07) mL was in the control group (P=0.000). It was mainly mild response of postoperative wound reaction in the experimental group in the first and third day after the operations, while mainly moderate response was in the control group, and there was no case of severe postoperative wound reaction in both groups. The differences of mild postoperative wound reaction in the first day and the third day between both groups were statistically significant (P=0.047 and P=0.000). The differences of moderate postoperative wound reaction in the first day and the third day between both groups were also statistically significant (P=0.047 and P=0.000). There was no recurrent hemorrhage case postoperatively in both groups. [Conclusion] Tonsillectomy with electricity dissectible knife could be performed easily and achieve homeostasis simultaneously, resulting in less blood loss and less side injury to the surrounding soft tissue, which is safer and more economical.