常规扁桃体剥离术的方法改进(1)
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[摘要] 目的：探讨常规扁桃体剥离术存在的缺陷及对此采取的改进措施。方法：回顾性分析2000年2月～2008年2月我科610例改良扁桃体切除手术与518例常规扁桃体剥离术患者的临床资料。改良手术采用以下改进措施，即：保留扁桃体三角皱襞黏膜；尽可能多保留扁桃体周围黏膜组织；采用可吸收线缝合扁桃体窝及三角皱襞黏膜。结果：改良手术与常规手术相比，患者术后疼痛、咽部异物感、口干、发音含糊持续时间明显减轻(P<0.05)；术后1年咽部变形发生率、扁桃体瘢痕、扁桃体残留为0，与常规手术组比较，差异有统计学意义(P<0.05)。结论：改良后的扁桃体剥离法与常规剥离法相比，术后出血、感染、咽干、咽部异物感明显减轻，粘连发生率低，有明显的优势，值得推广。
[关键词] 扁桃体；黏膜；缝合
[中图分类号] R766[文献标识码]A [文章编号]1673-7210(2010)10(a)-027-02
The improvement of conventional dissection tonsillectomy
DUAN Zhongning, XU Hengguang*, ZHANG Shujia
(Department of Otolaryngology, the First People′s Hospital of Lianyungang City, Jiangsu Province, Lianyungang 222002, China)
[Abstract] Objective: To explore the defects of conventional dissection tonsillectomy and the ways to improve it. Methods: A retrospective study of clinical data were conducted on 610 cases of patients with modified dissection tonsillectomy and 518 cases of patients with conventional dissection tonsillectomy from February 2000 to February 2008 in our dempartment. In the Modified operation, the following improvement measures were taken: to retain the mucosa of tonsil triangular folds; to retain the mucosa around the tonsil as much as possible; using absorbable suture to suture the mucosa of tonsillar fossa and triangular folds. Results: Compared with the patients who underwent conventional dissection tonsillectomy, the patients who underwent improved dissection tonsillectomy had less postoperative pain, pharyngeal foreign body sensation, dry mouth, significantly reduced the duration of pronunciation ambiguity (P<0.05). And after one year in the patients who underwent improved dissection tonsillectomy, the incidence of pharyngeal deformation, tonsil scars, tonsil residual were 0, which had significant differences with who underwent the conventional operations (P<0.05). Conclusion: There are significantly reduced postoperative bleeding, infection, pharyngeal dryness, pharyngeal foreign body sensation, and adhesion in the patients who underwent the improved dissection tonsillectomy, compared with ones who underwent the conventional dissection tonsillectomy ......
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