甲泼尼龙对扁桃体等离子切除术后并发症的影响

目的 评估静脉输注甲泼尼龙对扁桃体等离子切除术后恢复及术后并发症的影响.方法 观察2015年12月～2016年12月份于我科行双扁桃体等离子切除术的83例患者,采用随机、双盲的原则将低龄、高龄两组观察对象分别分为实验组及对照组,实验组术后静点甲泼尼龙观察患者术后反应,如疼痛程度、活动量、咽部水肿、身体情况、白膜脱落时间、继发性出血等多项指标.结果 ①术后3～5天,甲泼尼龙可减轻低龄组疼痛感(Z=4.42,P=0.00),增加患者活动量(Z=2.64,P=0.00)、减轻咽部水肿(Z=2.84、3.10,P均=0.00).②术后身体情况低龄实验组消化道不适发生率低于对照组(x2=4.97,P=0.03);高龄实验组消化道不适(x2=5.24,P=0.02)、睡眠障碍(x2=5.03,P=0.03)发生率均低于对照组.③白膜脱落情况在高龄实验组白膜脱落时间晚于对照组(t=2.16,P=0.04).④继发性出血两组之间无明显差异(x2=1.29,P=0.26).结论 扁桃体等离子切除术后静点甲泼尼龙在缓解疼痛、消化道不适、减轻水肿及延迟白膜脱落方面有效.

Effect of the methylprednisolone on postoperative reaction after coblation tonsillectomy

OBJECTIVE To evaluate the effect of intravenous infusion of methylprednisolone on postoperative recovery and complications after coblation tonsillectomy.METHODS Eighty three patients who were scheduled for coblation tonsillectomy from December 2015 to December 2016 were included in this study.Firstly,they were divided into 2 groups,i.e.,the younger group (＜12 years) and the older group (≥12 years old).Secondly,these two groups were further divided into experimental group and control group by the prospective,double-blind and randomized method.The experimental group was treated with methylprednisolone and antibiotics for 3 days.Then,the postoperative reactions such as the pain,activity,pharyngeal edema,body condition,exfoliation time of the tunic albuginea,post-tonsillectomy hemorrhage were observed.RESULTS 1.From the third day to fifth day,using methylprednisolone can alleviate pain (Z=4.42,P=0.00),increase the activity(Z=2.64,P=0.00)and reduce pharyngeal edema(Z=2.84,3.10,all P=0.00) in younger group.2.After operation,in the younger group,the incidence rate of gastrointestinal discomfort in control group was higher than that in experimental group(x2=4.97,P=0.03).In the older group,the incidence rate of gastrointestinal discomfort(x2=5.24,P=0.02) and sleep disturbance(x2=5.03,P=0.03) in control group was higher than those in experimental group.3.In the older group,exfoliation average time of the tunic albuginea in experimental group was longer than that in control group(t=2.16,P=0.04).4.Secondary bleeding rate was not statistically significant in the two groups(x2=1.29,P=0.26).CONCLUSION Intravenous infusion of methylprednisolone after coblation tonsillectomy is beneficial,especially in the relief of pain,gastrointestinal discomfort and pharyngeal edema.