超声刀在扁桃体肿瘤切除术中的应用体会

目的探讨超声刀在扁桃体肿瘤切除术中的应用体会。方法选择70例成人单侧扁桃体形态异常考虑肿瘤的患者,随机分为超声刀组(35例)和电刀组(35例),记录患者的一般情况、手术时间、术中出血、术后咽痛及并发症等情况,将两组患者的资料进行比较。结果两组患者男性居多,扁桃体以肥大或增生多见,且多为Ⅱ°大小。两组患者术后病理均以良性病变为多,最常见为慢性炎症,其次为乳头状瘤;恶性病变主要为淋巴瘤。超声刀组在手术时间及术中出血量方面要优于电刀组(P<0.001),而在术后继发性出血、术后感染及住院时间方面并无明显优势。超声刀组无术后原发性出血发生,电刀组有5例患者出现术后原发性出血,但二者间差异并无统计学意义(P=0.054)。术后第1天疼痛VAS评分超声刀组优于电刀组(P=0.009),而在术后第2、5、10天比较,差异无统计学意义。结论对于扁桃体肿瘤患者行扁桃体切除术而言,超声刀是一个理想的手术器械。

Application of the ultrasonic scalpel in tonsillectomy for biopsy of patients with suspected tonsillar tumor

Objective We aimed to explore the application of the ultrasonic scalpel in tonsillar tumor resection. Methods Seventy cases of adult patients with abnormally shaped unilateral tonsils suspected of being tumors were divided into ultrasonic scalpel(35 cases)and electric scalpel(35 cases)groups. The general clinical data, operation time, intraoperative blood loss, postoperative pharyngeal pain and complications of the patients were recorded, and the data of the two groups were compared. Results The postoperative pathologies of the two groups were revealed to be mostly benign lesions, with the most chronic inflammation, followed by papilloma and cysts. Most malignant lesions were lymphoma. The ultrasonic scalpel group was superior to the electrosurgical group in terms of operative time and intraoperative blood loss(P<0.001), although it exhibited no obvious advantages in terms of postoperative secondary bleeding, postoperative infection, and duration of hospitalization. No postoperative primary hemorrhage was observed in the ultrasonic scalpel group and 5 patients in the electrosurgical group; however, the difference between the two groups was not statistically significant(P=0.054). The pain visual analogue scale(VAS)score of the ultrasonic scalpel group on the first day after surgery was superior to that of the electrosurgical group(P=0.009), and the difference was not statistically significant at 2, 5, and 10 days after surgery. Conclusion The ultrasonic scalpel is an ideal surgical instrument for tonsillectomy in patients with suspected tonsillar tumors.