鼻内镜下腺样体切除术与常规腺样体刮除术的疗效比较

目的:比较鼻内镜下腺样体切除术与常规腺样体刮除术两种术式的疗效。方法:将资料完整的34例腺样体肥大患者分为鼻内镜下腺样体切除术18例(切除术组),常规腺样体刮除术16例(刮除术组);采用声反射鼻测量等参数观察手术疗效,随访6~12个月并进行回顾性分析。结果:切除术组平均手术时间5.25(1.25~15.75)min,刮除术组8.5(1.5~35.0)min,两组差异有统计学意义(P<0.01);切除术组平均出血量50(10~125)ml,刮除术组平均出血量75(5~175)ml,两组比较无统计学意义(P>0.05)。切除术组术后出血1例,刮除术组术后脱水1例。声反射鼻测量计检查鼻咽部最小横截面积,切除术组术前(0.75±0.58)cm2,术后3个月为(1.94±0.63)cm2,术后12个月为(1.99±0.44)cm2;刮除术组术前(0.80±0.51)cm2,术后3个月为(1.83±0.81)cm2,术后12个月(1.89±0.37)cm2。两组手术前后最小横截面积比较差异有统计学意义(均P<0.01),手术前后两组间最小横截面积比较差异均无统计学意义(均P>0.05)。结论:鼻内镜下腺样体切除术具有切除快、出血少等优点。声反射鼻测量计是评估腺样体切除术疗效的客观指标。

Comparion of the powered-assisted adenoidectomy with adenoid curette adenoidectomy

OBJECTIVE: To compare the outcomes of powered-assisted adenoidectomy with adenoid curette adenoidectomy. METHOD: Thirty-four cases with adenoidal hypertrophy were retrospectively analyzed in Shanghai Sixth Peoples Hospital between June 2003 to June 2004. All the patients were followed up six to twelve months. Of 34 cases, 18 children underwent powered-assisted adenoidectomy, and the rest underwent conventional transoral adenoidectomy using a curette. The surgical results were assessed by acoustic rhinometry. RESULT: The averaged time for endoscopic powered-assisted adenoidectomy was 5 minutes and 15 seconds and the time for conventional adenoidectomy was 8 minutes and 22 seconds. There was a significant difference (P < 0.01) between them. The blood loss during powered-assisted and conventional adenoidectomy was 50 (10-125) ml and 75 (5-175) ml respectively, but there was no difference (P > 0.05). One case after powered-assisted adenoidectomy happened bleeding, and one case after conventional adenoidectomy happened dehydration. There were increases in the cross-sectional area at the adenoid, (0.75 +/- 0.58) cm2 preoperatively and (1.94 +/- 0.63) cm2 three months postoperatively, (1.99 +/- 0.44) cm2 one year after operation in powered-assisted group, and (0.80 +/- 0.53) cm2 preoperatively and (1.83 +/- 0.81) cm2 three months postoperatively, (1.89 +/- 0.37) cm2 one year after operation in conventional group. Comparing the preoperative and postoperative cross-sectional area in both groups by acoustic rhinometry, a significant difference (P < 0.01) was found. CONCLUSION: Powered-assisted adenoidectomy has the advantages of shorter surgical time, and less blood loss. Acoustic rhinometry is a kind of objective parameter for assessing the outcome of adenoidectomy.