内镜下对传统腺样体刮除术的临床评估

目的在内镜直视下研究传统腺样体刮除术病变残留比率和残留的部位。方法对107例腺样体增生肥大患儿，其中腺样体Ⅱ度肥大64例，Ⅲ度肥大43例，先行传统腺样体刮除术，然后在内镜直视下观察是否有病变残留以及病变残留的大小和部位，对有病变残留的患儿在内镜直视下应用切割吸引器切除腺样体残留组织。结果行传统腺样体刮除术的所有患儿均有不同程度的病变残留，显著残留率（病变残留最大径超过1cm）53．1％（57／107），其中腺样体Ⅱ度肥大显著残留率25．0％（16／64），Ⅲ度肥大95．3％（41／43），残留位于腺样体上极35例（61．4％）、腺样体靠近圆枕处28例（49．1％）、腺样体下级16例（28．1％）。结论传统腺样体刮除术极易遗留病变组织，部位包括腺样体上极、腺样体靠近圆枕处、腺样体下级。

Endoscopy after traditional adenoidectomy

Objective To evaluate the effect of endoscopy after traditional adenoideetomy. Method 107 eases of adenoid hypotrophy including 43 eases of degree 11 and 64 eases of degree 11 were first treated by traditional adenoideetomy, then the remains were reraoved by endoscopy. Results Remains were found in all eases. In 57 eases, 41 （95.3%）eases of degree 11 and 16 （25.0%）eases of degree 11, the remains were longer than 1 cm. The remains of 35 （61.4%） eases were located in the upper part of the adenoid, of 16 （28.1% ） cases were located in the lower part of the adenoid, of 28 （49.1% ） cases were located near the pharyngeal ostium of the eustachian tube. Conclusion Traditional adenoidectomy is poor in that remaining tissues are mainly found in the upper part of the adenoid, the lower part of the adenoid and near the pharyngeal ostium of the eustachian tube.