儿童扁桃体、腺样体低温等离子切除术后出血的临床研究

目的 探讨应用低温等离子手术或者传统手术方式行儿童扁桃体、腺样体切除术在术后出血方面存在的差异。方法 回顾性分析1597例接受手术治疗的儿童慢性扁桃体炎、腺样体肥大的患者资料，行等离子射频辅助的扁桃体和(或)腺样体切除术者793例(等离子组)，行传统扁桃体切除和(或)腺样体者804例(传统组)。比较两组原发性及继发性出血的发生率、出血程度和出血部位的差异。结果 等离子组发生术后出血25例(3.2％)，传统组出血19例(2.4％)，两组间差异无统计学意义(χ2=3．34，P>0．05)；其中等离子组原发性出血9例(1.1％)，继发性出血16例(2.0％)；传统组原发性出血11例(1.4％)，继发性出血8例(1．0％)，两者比较差异有统计学意义(χ2=9．45，P<0．01)。两组术后的出血部位经卡方检验，出血程度经Wilcoxon秩和检验，P值均>0．05，差异均无统计学意义。结论 低温等离子辅助行儿童扁桃体、腺样体切除术，在术后出血的发生率、程度、部位三个方面相对于传统的手术方法治疗，二者差异无统计学意义。

Hemorrhage following coblation-assisted tonsillectomy and adenoidectomy in children

Objective To investigate the postoperative bleeding of coblation-assisted and traditional operation in children’s tonsillectomy and/or adenoidectomy. Methods Data of 1597 children with tonsillitis and adenoid hypertrophy, who underwent traditional(804 cases) or coblation-assisted (793 cases) operation between January 1，2007 and December 30，2011, were reviewed．Incidence of hemorrhage, severity and location between the two groups were compared． Results Postoperative hemorrhage occurred in 25 patients with coblation assisted operation (3.2％) and 19 patients with traditional operation (2.4％) (χ2=3.34， P>0.05). There was no difference in the site (χ2=0.736， P=0.085) or incidence (Z=0.392， P=0．614) . Significant difference was found in the interval of hemorrhage after surgery between the two surgical techniques(χ2=9.45， P<0．01). Conclusion There is no difference in the postoperative hemorrhage for coblation assisted or traditional tonsillectomy and adenoidectomy in children.