单极电凝不同功率切除扁桃体的临床应用

　　[摘要]目的 比较使用单极电凝三种不同功率在扁桃体切除中的临床特点。 方法 选择自2015年1月以来近3年我科收治的需要切除扁桃体的手术患者共90例。90例应用单极电凝行扁桃体切除术的患者按单极电凝的三种功率17 W、27 W、37 W隨机分为三组，每组各30例，比较三组术中术后临床指标，根据临床指标进行分析。结果 27 W组、37 W组患者术中出血量、手术时间与17 W组之间差异分别有显著性（P<0.05），27 W组、37 W组之间差异无显著性（P>0.05）；17 W组、27 W组患者的悬雍垂水肿消退时间、术后恢复正常饮食时间、疼痛评分、创面黏膜上皮化时间与37 W组之间差异分别有显著性（P<0.05），17 W组、27 W组之间差异无显著性（P>0.05）；三组患者原发性出血率、继发性出血率差异均无显著性（P>0.05）。 结论 单极电凝术切除扁桃体安全可靠，最适宜功率为27 W，值得在国内推广应用。
　　[关键词] 扁桃体切除术；单极电凝；功率；热损伤
　　[中图分类号] R766.9 [文献标识码] A [文章编号] 1673-9701（2018）08-0012-03
　　Clinical application of unipolar electrocoagulation with different powers in tonsillectomy
　　XU Jingsheng1，2 WANG Huihe2 LIU Tingyan3
　　1.Binzhou Medical University，Yantai 264000， China；2.Department of E.N.T. and Head and Neck Surgery， Chengyang District People"s Hospital， Qingdao 266000， China；3.Department of E.N.T. and Head and Neck Surgery， Yantai Affiliated Hospital of Binzhou Medical University， Yantai 264000， China
　　[Abstract] Objective To compare the clinical features of unipolar electrocoagulation with three different powers in tonsillectomy. Methods A total of 90 patients undergoing surgery for tonsillectomy in our department for the recent 3 years from January 2015 were selected as the research subjects. 90 patients receiving unipolar electrocoagulation for tonsillectomy were randomly divided into 17 W group， 27 W group， and 37 W group according to the three powers of 17 W， 27 W， 37 W in unipolar electrocoagulation， with 30 cases in each group. The intraoperative and postoperative clinical indicators were compared. Analysis was carried out based on clinical indicators. Results The intraoperative blood loss， operation time in 27 W group， 37 W group and 17 W group were significantly different （P<0.05）. There was no significant difference between 27 W group and 37 W group（P>0.05）；there were significant differences in subsiding time of uvula edema， duration of postoperative normal diet， pain score， wound mucosal epithelialization time between the 17 W group， the 27 W group and the 37 W group（P<0.05）， and there was no significant difference between 17 W group and 27 W group（P>0.05）；there was no significant difference in the rates of primary hemorrhage and secondary hemorrhage between 17 W， 27 W and 37 W groups（P>0.05）. Conclusion Unipolar electrocoagulation for the resection of tonsils is safe and reliable， and the most suitable power is 27 W， which is worthy of promotion and application in China.
　　[Key words] Tonsillectomy；Unipolar electrocoagulation；Power；Heat damage