腺样体吸切联合等离子消融术治疗腺样体肥大疗效观察

目的 比较鼻内镜下腺样体吸切术联合局部低温等离子消融术和单纯鼻内镜下腺样体吸切术治疗腺样体肥大的疗效,探讨腺样体肥大患儿最佳手术方式的选择.方法 对2013年6月至2015年6月在西安市北方医院进行手术治疗的92例腺样体肥大患儿的临床资料进行回顾性分析,根据采用术式的不同分为观察组(n=50 )和对照组(n=42 ),观察组采用鼻内镜下腺样体吸切术联合局部低温等离子消融术;对照组采用鼻内镜下腺样体吸切术,比较两种术式治疗腺样体肥大的疗效.结果 术后6个月两组患儿睡眠打鼾、张口呼吸、耳闷、鼻塞和流涕症状等疗效方面比较,观察组明显优于对照组,差异有统计学意义(P<0.05);两组患儿在分泌性中耳炎的疗效方面比较,观察组明显优于对照组,差异有统计学意义(P<0.05).结论 腺样体肥大的患儿采用鼻内镜下腺样体吸切术联合局部低温等离子消融术去除鼻咽部慢性感染灶,可以有效阻止淋巴组织的再次增生,改善咽鼓管功能,提高手术治疗效果,其疗效明显优于单纯鼻内镜下腺样体吸切术.

Observation of the Curative Effect of Adenoid Adenoidectomy Combined with Plasma Ablation in Treatment of Adenoid Hypertrophy

Objective To study the selection of surgical methods for children with adenoid hypertrophy by comparing the curative effect of the nasal endoscopic adenoidectomy combined with local hypothermia plasma ablation and the nasal endoscopic adenoidectomy.Methods The clinical data of 92 children with adenoid hypertrophy treated from June of 2013 to June of 2015 in Northern Hospital of Xi'an were analyzed retrospectively. All the cases were divided into the observation group (n=50)and control group (n=42)according to the surgical method.The observation group received the nasal endoscopic adenoidectomy combined with local hypothermia plasma ablation,while the control group was treated with the nasal endoscopic adenoidectomy.Then the curative effect of the two groups was compared.Results The observation group was significantly better than the control group 6 months after operation in sleep snoring,mouth breathing,aural fullness,nasal congestion and runny nose (P<0.05).The curative effect in treatment of secretory otitis media was also significantly better in the observation group than in the control group (P<0.05).Conclusion The nasal endoscopic adenoidectomy combined with local hypothermia plasma ablation can effectively prevent the lymphoid tissue from re-proliferation,improve the function of eustachian tube and ameliorate the effect of surgical treatment in the removal of nasopharyngeal chronic infection in children with adenoid hypertrophy,and it has better curative effect than the nasal endoscopic adenoidectomy.