双极电凝在全身麻醉下扁桃体摘除术中的应用

目的 探讨双极电凝在全身麻醉下扁桃体摘除术中的应用效果。方法 全身麻醉下采用双极电凝、单极电刀与传统剥离法实施扁桃体摘除,三种术式共实施扁桃体摘除65例。比较各术式对应的手术时间、术中出血量及术后并发症、疼痛程度及恢复时间。结果 用双极电凝镊行扁桃体摘除在包埋型扁桃体、扁桃体周围明显粘连患者中与单极电刀及传统的剥离法扁桃体摘除相比,术时短,术中出血少,术后并发症发生率低。结论 全身麻醉下,采用双极电凝扁桃体摘除手术尤其适用于包埋型扁桃体以及扁桃体周围明显粘连的患者。     

低温等离子刀与双极电凝在扁桃体切除术中的疗效比较

目的比较低温等离子射频消融术与双极电凝法对扁桃体切除术患者的临床疗效。方法选取我院于2012年6月-2014年8月收治的82例行双侧扁桃体切除术的成人患者为研究对象,将其分为观察组与对照组,观察组采用低温等离子刀切除扁桃体,对照组采用双极电凝切除扁桃体。比较两组扁桃体切除时间、术中出血量、术后疼痛程度、恢复正常饮食时间、假膜脱落时间。结果观察组切除扁桃体手术时间、术中出血量均较对照组少,且比对照组更早恢复正常饮食,术后疼痛也较对照组轻,假膜脱落时间也短于对照组,差异均有统计学意义（P〈0.05）。结论低温等离子刀切除扁桃体具有术中出血少、手术时间短、安全有效等优势,值得临床推广应用。     

双极电凝器在扁桃体切除术中的应用

20 0 0年 6月～ 2 0 0 2年 7月 ,我科在 2 1 8例扁桃体切除术中应用双极电凝器 (上海沪通电子有限公司ＧＤ3 5 0 Ｓ3型 )止血 ,取得了良好效果。报告如下。1　资料与方法1 .1 　 临床资料2 0 0 0年 6月～ 2 0 0 2年 7月行扁桃体切除术2 1 8例 (电凝组 ) ,男 1 2 2例 ,女 96例 ;年龄 5～ 5 2岁。病程 3个月～ 1 0年。局部麻醉 1 41例 ,全身麻醉 77例。1 998年 5月～ 2 0 0 0年 5月行扁桃体切除术1 93例 (对照组 ) ,男 1 0 3例 ,女 90例 ;年龄 6～ 5 5岁。病程 4个月～ 1 6年。局部麻醉 1 2 4例 ,全身麻醉 6 9例。1 .2 　 手术方法两组病例术…     

双极电凝在鼻中隔结节治疗中的应用

鼻中隔结节多发生于鼻中隔高位近中鼻甲处，系中隔黏膜局限性肥厚形成的突起，以探针触及，质地柔软。鼻中鼻结节多伴有鼻中隔偏曲，单纯鼻中隔结节而无鼻中隔偏曲者少见。在行鼻中隔纠正术中，伴有鼻中隔结节者，作者主张同期以双极电凝处理，否则鼻中隔结节未处理者，术后鼻中隔偏曲又“弹回”，影响鼻腔通气。我科1998～2005年收治鼻中隔结节者86例，术中均以双极电凝治疗鼻中隔结节，效果理想，鼻中隔偏曲术后不再“弹回”，无1例出现鼻中隔穿孔和术后出血，报道如下。     

射频双极电凝治疗鼻出血

鼻出血是耳鼻咽喉科常见疾病，有时处理十分棘手。我们自1993年开始用射频双极电凝器治疗鼻出血32例，取得了满意的疗效，特予报道。1资料与方法1·1临床资料32例中，男24例，女8例，年龄32～78岁，合并高血压8例，鼻中隔偏曲5例，鼻外伤4例，血小板减少2例，凝血因子江缺乏1例     

双极电凝镊联合显微镜在儿童先天性耳前瘘管感染期手术治疗中的经验总结

目的探讨双极电凝联合显微镜在儿童先天性耳前瘘管感染期手术中的应用, 分析总结其安全性和可行性。方法总结分析亳州市人医院2018年1月至2020年12月收住院并行手术治疗的感染期先天性耳前瘘管患儿50例, 年龄1～11岁, 平均年龄6.5岁, 均为单侧感染期手术, 术前明确耳前瘘管合并感染, 经抗炎治疗并根据情况切开引流换药3～5次后及时行手术治疗, 手术采用全身麻醉, 术中使用双极电凝配合显微镜完全切除瘘管组织, 同时清理感染灶, 术前切开引流口根据情况在术中尽可能采取缝合措施。结果术后46例愈合良好, 按时拆线, 4例术后切口延迟愈合, 经积极换药后痊愈。常规随访半年, 无复发病例。结论先天性耳前瘘管患儿感染期手术可以有效减少感染期反复换药对患儿带来的痛苦, 同时双极电凝联合显微镜感染期手术可以达到更好地控制出血、彻底分离并切除瘘管组织, 术后随访无复发病例, 值得临床推广。     

扁桃体周围脓肿期行扁桃体摘除术的疗效观察

为观察扁桃体周围脓肿期行扁桃体摘除术的安全性 ,现将我科 1 995～ 1 999年于扁桃体周围脓肿期行扁桃体摘除术 54例的临床资料与同期行常规扁桃体摘除术 50例的资料进行比较分析 ,报告如下。1　资料与方法1 .1 　 临床资料扁桃体周围脓肿患者 54例 (脓肿组 ) ,其中男2 9例 ,女 2 5例 ;年龄 1 6～ 52岁。病程 2 d～ 3年。全部为单侧急性感染病例 ,表现为单侧咽痛、发热 ,张口及吞咽受限。检查见患侧咽充血肿胀 ,腭舌弓上部膨隆 ,扁桃体推向内下方。同期慢性扁桃体炎或病灶型扁桃体炎患者 50例 (对照组 ) ,其中男 2 8例 ,女 2 2例 ;年龄 1 3…     

成人与儿童单极电凝扁桃体切除术的比较研究

目的:探讨成人与儿童单极电凝扁桃体切除术的临床特点。方法:选取行单极电凝扁桃体切除术的成人(成人组)及儿童(儿童组)患者各40例,手术均由同一术者完成。记录并比较2组术中术后的临床参数。结果:成人组和儿童组手术时间分别为(32.625±8.320)min和(21.250±3.881)min,术中出血分别为(18.725±9.538)ml和(4.825±1.866)ml,恢复正常饮食时间分别为(13.950±0.714)d和(10.000±0.679)d,2组比较差异均有统计学意义(P<0.05)。2组患者术后1周内疼痛分值比较,差异有统计学意义(P<0.05),第14天时疼痛分值比较,差异无统计学意义(P>0.05)。2组均无明显术后出血,创面黏膜化于2周时比较差异无统计学意义,术后体温比较差异无统计学意义。结论:成人及儿童单极电凝扁桃体切除术安全、操作简便,值得临床应用。     

低温等离子刀对比双极电凝镊在扁桃体切除术中治疗效果观察

目的分析变应性鼻炎(AR)患者接受鼻腔冲洗治疗的临床疗效。方法将2019年6月~2020年8月作为研究时间段,选取期间我院接诊的78例AR患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入39例)、研究组(加用鼻腔冲洗治疗,纳入39例),对组间气道反应性、症状消失时间展开分析。结果(1)组间气道反应性指标在治疗前无明显差异,P>0.05;研究组共振频率(Fres)、中心气道阻力(R20)、气道总阻力(R5)在治疗后低于对照组,P<0.05;(2)研究组鼻塞、流涕、喷嚏、鼻痒消失时间均少于对照组,P<0.05。结论鼻腔冲洗对改善AR患者气道反应、临床症状均有明显效果,值得推广。     

Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy

Coblation tonsillectomy has shown promising results with respect to postoperative pain when compared with other techniques. Our study was designed to compare this technique with bipolar scissor tonsillectomy. Forty adult patients with a history of chronic or recurrent tonsillitis referred for standard tonsillectomy were recruited and randomized into two groups. Twenty were operated with Coblator and 20 with bipolar scissors. Exclusion criteria were a history of quinsy, bleeding disorder, or any major health problems. All participants completed the study. Postoperative pain, return to normal diet, and estimated need for sick leave were utilized as parameters. Data on operative time, difficulty of tissue removal, and hemostasis were also analyzed. Operative time was longer (P < 0.001) and tissue removal as well as hemostasis control were more difficult (P = 0.005, P = 0.013) with Coblator than with bipolar scissors. Participants in Coblator group assessed higher pain scores 1 and 3 h postoperatively (P = 0.044, P = 0.036). From the time of extubation, patients had access to an opioid (fentanyl) via a self-controlled analgesia device. The number of doses of analgesics needed during the hospital stay was significantly higher in the Coblator group (P = 0.020). During the 14-day follow-up, no significant differences were found in pain scores, return to solid food or subjective working ability between the groups. Considering the overall outcome of the patients the results did not favor coblation technique over bipolar scissors.     

Ligation vs. bipolar diathermy for haemostasis in tonsillectomy—a comparative study

The use of diathermy for haemostasis in Tonsillectomy remains controversial. A thorough scan of English literature comparing the ligation with diathermy has been presented. The reasoning of using Bipolar instead of Unipolar is explained. A prospective randomized study of 376 tonsillectomy is being presented. This is the first study in India where Bipolar instead of Unipolar diathermy is being used. No significant difference was found in P.O. Hg. rates when either diathermy or ligatures were used. Diathermy is significantly faster method of securing haemostasis resulting in shorter operative a & anesthetic time, thus saving on cost. Long term follow-up has shown better results with diathermy & is associated with less pharyngitis, hyper-trophied nodes & resulis in more smooth tonsillar fossae.     

Bipolar electrodissection tonsillectomy in children

The purpose of this study was to compare bipolar electrodissection tonsillectomy with traditional cold dissection tonsillectomy in the pediatric population. Forty children with recurrent tonsillitis and/or obstructive symptoms were included in the study. The study population was randomly divided into two groups, and the two techniques were compared with regard to operative time, intraoperative and postoperative bleeding and postoperative pain. There were 23 children in the bipolar electrodissection tonsillectomy group (mean age, 8.1 years; range, 5–12 years), and 17 children in the cold dissection tonsillectomy group (mean age, 6.7 years; range, 5–12 years). The average operative times were 15.2±8.5 min for bipolar electrodissection tonsillectomy and 29.06±13.5 min for cold dissection tonsillectomy (P<0.05). The blood loss in bipolar electrodissection tonsillectomy and cold dissection tonsillectomy was 5.0±4.2 ml and 32.1±11.3 ml, respectively (P<0.05). Postoperative hemorrhage was not observed. Bipolar electrodissection tonsillectomy was less painful the first 30 min postoperatively (P<0.05). Bipolar electrodissection tonsillectomy in children is a useful technique, with results comparable to traditional cold dissection tonsillectomy.     

Comparison of bipolar scissors and bipolar forceps in tonsillectomy

Bipolar diathermy scissors tonsillectomy is a relatively new surgical technique. We conducted a prospective study of 90 patients to compare this technique with bipolar forceps tonsillectomy. We found that the use of the bipolar scissors required significantly less operating time (mean: 3.03 min less) and allowed patients to resume eating solid food more rapidly (mean: 40.35 min earlier). Bipolar scissors tonsillectomy was safe, and there were no intraoperative complications or primary hemorrhages. A postoperative follow-up telephone survey revealed that patients who underwent scissors tonsillectomy experienced no more morbidity than did the forceps group during the first 2 weeks after surgery. We conclude that bipolar scissors tonsillectomy is a safe and rapid technique that can be used successfully as an outpatient procedure.     

Comparing the effectiveness of “plasma knife” tonsillectomy with two well-established tonsillectomy techniques: Cold dissection and bipolar electrocautery. A Prospective randomized Study

Objective

To evaluate the effectiveness of a new device “plasma knife” for tonsillectomy by comparing to two well-established tonsillectomy techniques: cold dissection, and bipolar electrocautery.

Methods

A prospective, randomized study conducted on 110 patients undergoing tonsillectomy. Subjects were randomized to plasma knife (PKT), cold dissection (CDT) and bipolar electrocautery (BET) groups. Operative time, intraoperative blood loss and postoperative complications were recorded. Pain/discomfort level of patients and healing time of the tonsillar fossae were assessed postoperatively. Data were recorded and statistically analyzed.

Results

Operative time with plasma knife and bipolar electrocautery were associated with a significant decrease in operative time compared to cold dissection (p < 0.05). Intraoperative blood loss was significantly decreased with plasma knife, compared to cold dissection and bipolar electrocautery (p < 0.05). Less postoperative pain was observed with plasma knife compared to bipolar electrocautery but more postoperative pain was observed with both compared to CDT (p < 0.05). Postoperative healing time was longer with plasma knife and bipolar electrocautery, compared to cold dissection (p < 0.05).

Conclusion

Plasma knife is a useful and safe device in tonsillectomy. Its use reduces intraoperative blood loss and provides a fast tonsillectomy with acceptable morbidity.     

The use of the bipolar microcoagulator for haemostasis in tonsillectomy

The use of the bipolar microcoagulator for haemostasis in tonsillectomy A two-part prospective trial of the use of bipolar diathermy for haemostasis in tonsillectomy was carried out. The first part of the trial showed that bipolar diathermy was as effective as conventional methods of dealing with bleeding, and has no additional undesirable effects. The second part showed that the method could substantially reduce operating time.