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目的:分析低温等离子辅助儿童腺样体、扁桃体手术的并发症情况。方法:对2 089例低温等离子辅助下儿童腺样体、扁桃体手术病例进行回顾性分析,采用流行病学方法对病例人群的一般情况、手术方式、术中及术后并发症情况进行调查分析。结果:(1)2 089例病例中,男1 411例,女678例,男女比例2.08:1;年龄(5.87±3.12)岁,其中3~7岁最多,占76.35%(1 595/2 089)。(2)全部病例均行腺样体切除术,扁桃体采用部分切除术69.17%(1 445/2 089),单纯打孔扁桃体消融术占22.26%(465/2 089),扁桃体全切除术占8.57%(179/2089);手术时间(30.15±8.26)min,术中出血量(8.52±3.18)ml,术后疼痛评分(3.77±1.61)分。(3)术后并发症的发生情况为出血5例(0.24%)、复发3例(0.14%)、椎前淋巴结炎20例(0.96%)、其他6例(圆枕增生2例、呼吸困难2例、烫伤1例、鼻咽粘连1例,0.29%),术后发热205例(9.81%)。结论:低温等离子技术是一治疗儿童腺样体、扁桃体疾病的高效、低并发症的好方法。但提高手术操作熟练程度及技巧是减少并发症的重要环节。
OBJECTIVE: To analyze the complications of adenoid and tonsil surgery assisted by plasma at low temperature. Methods: A retrospective analysis of 2 089 cases of adenoid and tonsil surgery assisted by low-temperature plasma was conducted. The general situation, operation method, intraoperative and postoperative complications of children were investigated by epidemiological method. Results: (1) Of the 2,089 cases, there were 1 411 men and 678 females, the ratio of male to female was 2.08: 1; the age was 5.87 ± 3.12 years old, of which 3 to 7 years old was the most, accounting for 76.35% (1 595/2 089) ). (2) Adenotubes resection was performed in all cases. Partial tonsillectomy was performed in 69.17% (1 445/2 089), simple perforation tonsil ablation was in 22.26% (465/2 089), total tonsillectomy was 8.57 % (179/2089); operation time (30.15 ± 8.26) min, intraoperative blood loss (8.52 ± 3.18) ml, postoperative pain score (3.77 ± 1.61) points. (3) Postoperative complications occurred in 5 cases (0.24%), recurrence in 3 cases (0.14%), prevertebral lymphadenitis in 20 cases (0.96%) and other 6 cases (occipital hyperplasia in 2 cases, dyspnea 2 cases, 1 case of scald, 1 case of nasopharyngeal adhesions, 0.29%), postoperative fever in 205 cases (9.81%). Conclusion: Low-temperature plasma technique is a good method to treat children with adenoid and tonsillar diseases with high efficiency and low complication. However, improving surgical proficiency and skills is an important part of reducing complications.