等离子射频消融术与常规剪切术治疗会厌囊肿疗效比较

目的 探讨低温等离子射频切除术治疗成人会厌囊肿的效果以及与常规剪切术相比的优势.方法 60例成年患者,随机分为等离子射频切除组与常规剪切组,低温等离子射频切除组应用ArthroCare(美国)系统及Evac70刀头,常规剪切组应用腹腔镜剪刀进行常规剪切及止血,双盲观察记录两种方法的手术时间、术后疼痛VAS评分、会厌充血肿胀程度、伪膜脱落情况及术后并发症.结果 等离子射频切除组手术时间快于常规剪切组,术后第1～6天等离子射频切除组疼痛低于常规剪切组,伪膜开始脱落时间不存在差异,术后第8天等离子射频切除组伪膜脱落更多,术后第1～3天等离子射频切除组充血会厌肿胀更轻,两组患者均未发生术后呼吸困难及出血.术后随访12个月,所有患者均无复发.结论 低温等离子射频切除会厌囊肿效果较好,与常规剪切术相比,手术时间短,患者术后前6天疼痛更轻,恢复更快.

Coblation and routine excision to treat epiglottic cysts

Objective To compare the effectiveness of coblation and routine excison in the treatment of epiglottic cysts. Method sixty adult patients with epiglottic cysts were randomly divided into coblation group (ArthroCare Evac 70 ArthroWand) or routine dissection group (cold instruments). The operating time and postoperative pain were assessed by VAS. The postoperative epiglottic edema, pseudomembrane time, as well as complications, were observed in a double blind fasion. Result The operating time was shorter in coblation group,which also presented less complaint of pain 1-6 days after surgery and smaller extent of epiglottic edema 1-3 days after surgery, but, more pseudomembrane shed off on the 8th day. No difference was found in the beginning time of defilming. No dyspnea or hemorrhage occurred in both groups. No recurrence was observed 12 months after the surgery. Conclusion Comparing with conventional procedure, coblation assisted dissection can shorten operation time and reduce the postoperative pain.