单极电刀凝切法在扁桃体切除术中的临床应用

目的 观察单极电刀凝切法在扁桃体切除术中的临床疗效.方法 回顾性分析52例在全麻下应用单极电刀凝切法切除扁桃体患者的临床资料,其中慢性扁桃体炎11例,扁桃体肥大Ⅱ～Ⅲ度伴有腺样体肥大28例,扁桃体角化症1例,阻塞性睡眠呼吸暂停低通气综合征（OSAHS）需行H-UPPP患者10例,另外2例扁桃体乳头状瘤患者行患侧扁桃体及新生物一并切除.探讨该手术方法的优点.结果 52例患者术中、术后均无大出血,每侧扁桃体切除时间一般为8 min左右,最长不超过15 min,术中出血少,出血量平均小于5ml,最多不超过10ml,且术后无大出血及腺体残留.术后咽痛1～2d,舌腭弓、咽腭弓及悬雍垂肿胀轻,自觉疼痛轻,不需镇痛治疗.结论 全麻下应用单极电刀凝切法切除扁桃体,术野清楚,术中出血少,手术用时短,设备简单,易于临床推广.

Clinical application of monopolar electrocautery in tonsillectomy

Objective To observe the clinical efficacy of monopolar electrocautery in the operation of tonsillectomy. Meth- ods The clinical data of 52 patients undergoing tonsillectomy using monopolar electrocautery under general anesthesia were analyzed retrospectively. In which 11 cases were with chronic tonsillitis ,28 cases with tonsil hypertrophy（ II - DI de- gree） and adenoidal hypertrophy, 1 case with keratosis of tonsil, 10 cases with obstructive sleep apnea hypopnea syndrome （OSAHS） needed for H-UPPP,and 2 cases with tonsil papilloma undergoing the resection of affected side tonsil and neo- plasm. The advantage of this operation method was evaluated. Results There was no intraoperative or postoperative bleeding in all 52 patients. The operation time of tonsillectomy for each side of tonsil was about 8 min, the longest no more than 15 min ;the blood loss was less, average less than 5 mL, not more than 10 mL; there was no postoperative bleeding and residual tonsil tissue. The postoperative sore throat lased for 1 to 2 d, the swelling of arcus glossopalatinus, arcus pha- ryngopalatinus and uvula was light;the feeling pains were light that needed not analgesic treatment. Conclusion The ton- sillectomy using monopolar electrocautery under general anesthesia is preferable in clear surgical field, less blood loss, shorter operation time and simple equipment, and easy to be widely used in clinic.