摘要
目的对传统的腺样体刮除术、鼻内镜下腺样体切吸术、腺样体刮除+鼻内镜下残余腺样体咬切术、鼻内镜下腺样体等离子融切术4种手术方法治疗腺样体肥大进行效果观察及对比研究。方法选取重庆市万州区第五人民医院耳鼻咽喉头颈外科2012年4月至2015年4月收治的148例腺样体肥大患者为研究对象,根据入院时间顺序分为4组,每组37例。A组采用传统的腺样体刮除术;B组采用鼻内镜下腺样体切吸术;C组予以腺样体刮除+鼻内镜下残余腺样体咬切术联合治疗;D组采用鼻内镜下腺样体等离子融切术治疗。观察各组的治疗效果、手术时间、出血量;术后随访半年,比较各组患者腺样体残留率及并发症发生情况。结果其中B、C、D组总有效率显著高于A组患者(χ2=7.731、5.045、7.731,P<0.05),但3组间有效率差异无统计学意义(P>0.05)。B、C、D组手术时间显著高于A组患者(t=5.819、5.829、2.759,P<0.05);B、C组比D组手术时间长(t=3.555、3.637,P<0.05),差异具有统计学意义;但B、C组间手术时间差异无统计学意义(t=0.149,P>0.05)。B、C组出血量相较于A组明显较高(t=9.305、4.126,P<0.05);D组显著低于A、B、C组(t=8.054、16.559、12.837,P<0.05);而B组显著高于C组出血量(t=5.739,P<0.05)。A组残留率明显高于其他3组(χ2=31.308、31.308、24.667,P<0.05),B、C、D组残留率均较低,差异无统计学意义(P>0.05)。4组间并发症发生率差异并无统计学意义(P>0.05)。结论 4种手术方式治疗腺样体肥大各有利弊,应根据患者自身状况和经济情况选择合适的手术治疗方式。
Objective To explore the effection of four types of surgery for the treatment of adenoid hypertrophy . Methods 148 cases of with adenoid hypertrophy treated in our hospital between April 2012 and April 2015 were chose;they were randomly divided into 4 groups ,each group of 37 people .A group of patients with adenoid hypertrophy were taken traditional ade‐noidectomy curettage;Group B with nasal endoscopic adenoidectomy and cutting aspiration biopsy ;Group C by adenoidectomy shave their ＋ residual endoscopic adenoidectomy bit cut method combined treatment ;Group D with nasal endoscopic adenoidectomy plas‐ma cutting treatment .The curative effect ,operation time ,blood loss were observed ;patients were followed‐up for half a year ,ade‐noidectomy residual rate and complications of each group were compared .Results The total effective rate of B ,C ,D three groups were significantly higher in group A patients （χ2 =7 .731 ,5 .045 ,7 .731 ,P〈0 .05） ,the efficient between three groups was not sta‐tistically different （P〉0 .05） .B ,C ,D three groups of operation time is significantly higher than A group of patients （t=5 .819 , 5 .829 ,2 .759 ,P〈0 .05）;B and C group had long operation time than group D （t=3 .555 ,3 .637 ,P〈0 .05）;But operation time of B and C had no significant difference between the two groups （t=0 .149 ,P〉0 .149） .Bleeding of B and C group were significantly higher than group A （t=9 .305 ,4 .126 ,P〈0 .05）;Group D was significantly lower than A ,B ,C three group （t=8 .054 ,16 .559 , 12 .837 ,P〈0 .05）;Group C and group B was significantly higher than the bleeding （t=5 .739 ,P〈0 .05） .Retention rate of group A is significantly higher than the other three groups （χ2 =31 .308 ,31 .308 ,24 .667 ,P〈0 .05） ,the residual rate of B ,C ,B group were lower ,there was no statistically significant difference（P〉 0 .05） .Complication rates between the four groups was no statistical difference（P〉0 .05） .Conclusion we should choose the right means of surgical treatment according to patients condition and eco‐nomic situation to .
出处
《重庆医学》
CAS
北大核心
2016年第27期3808-3810,3813,共4页
Chongqing medicine
关键词
腺样体切除术
对比研究
腺样体肥大
鼻内镜
等离子融切术
adenoidectomy
comparative study
adenoid hypertrophy
nasal endoscopy
plasma melting cut method
