摘要
目的总结鼻内镜下三种不同的手术方法治疗儿童腺样体肥大的经验,探索最佳的治疗方案。方法选择2009年6月～2011年10月全麻下经鼻内镜腺样体切除患儿1148例,应用90°成人鼻内镜经口腔径路低温等离子切除腺样体368例,90°成人鼻内镜经口腔径路Medtronic动力系统切吸术切除腺样体肥大677例,0°小儿鼻内镜下经鼻腔径路Medtronic动力系统切除腺样体103例。结果9 0°成人鼻内镜下口腔径路低温等离子切除腺样体的3 6 8例患儿术后无明显疼痛和出血,基本不影响进食;90°成人鼻内镜经口腔径路Medtronic动力系统切吸术切除腺样体的677例患儿中有较明显的疼痛,术后出血7例,占1.03%;0°小儿鼻内镜经鼻腔Medtronic动力系统切除腺样体手术时间长,操作困难,术后需要鼻腔填塞。结论 90°成人鼻内镜经口腔径路Medtronic动力系统切吸术和等离子消融术治疗腺样体肥大是很好的微创手术方法,但笔者更倾向于应用等离子消融术。
Objective To explore the optimal scheme for the treatment of adenoid hypertrophy in children via summarization of clinical experience of endoscopic adenoideetomy with three different kinds of surgical methods. Methods From June 2009 to Oct 2011, 1148 children with adenoid hypertrophy received endoscopic adenoideetomy under general anaesthesia. Of them, low temperature plasma ablation was applied to 368 eases, Medtronie power system via oral approach was applied to 677, and Medtronic power system via nasal approach to 103 cases. Results After operation, 368 patients receiving low temperature plasma adenoideetomy had no obvious pain and postoperative bleeding, and their feeding wasn＇t affected. All the cases treated with Medtronie power system via oral approach had obvious pain, and postoperative bleeding occurred in 7 of them （1. 03% ）. As for the adenoidectomy with Medtronie power system via nasal approach, the operation time was long with difficuhy of manipulation and postoperative nasal packing. Conclusion For adenoid hypertrophy in children, endoscopic adenoidectomy via oral approach with either Medtronie power system or low temperature plasma ablation is commendable with minimal invasion. According to my experience, the latter is predisposed.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2012年第6期438-440,共3页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
