冷、热止血法与扁桃体切除术后疼痛关系的比较研究.pdfVIP

中国中西医结合耳肄咽喉 生箜!鲞笙 塑 347 冷、热止血法与扁桃体切除术后疼痛关系的 比较研究 宋岩 白伟 良 王铁 季文樾。 【摘要】目的 观察电凝器喷凝止血法(热止血法)和压迫缝扎止血法(冷止血法)与扁桃体切除术后疼痛的相关性。方法 行扁桃体摘除术的慢性扁桃体炎患者100例，分为2组，术中分别采用冷止血法和热止血法进行创面止血。分别记录术中出血 量，术后每天观察进食情况以记录正常进食时间；采用McGill疼痛量表法，于术后第3天进行疼痛评分并作组问比较分析。结 果 热止血法组病例的术中平均出血量及术后进食时间分别为10．26_+0．69ml~H2．52±0．42d，而冷止血法组病例则分别为 l2．52±0．45ml及2．12±0．63d(P0．05)；比较术后疼痛持续时间，热止血法组病例有3个指标明显大于冷止血法组，仅1个指 标明显短于后者(均P0．05)，其余指标组间差异无统计学意义(P0．05)。结论 热止血法手术操作较安全，术中出血量较少， 但术后疼痛较明显。因而，应根据患者术中的具体情况灵活选择止血方法。 【关键词】扁桃体切除术；术后疼痛；止血法；术后影响 Comparativestudyonthepossibleimplicationsof w‘arm ’or c‘old’ hemostaticproceduresperformedduringtonsillectomyinp0st一0peratiVe localpain SONGYan，17A[ eiliang,IfANGTie．JIifenyue Dept．ofOtolaryngology,ChinaMedicalEniversity ShengjingHospitaLLiaoning．110004,China [Abstract]0bjectiveToinvestigatethepossibleimplicationsofwarm’orcold’hemostaticproceduresperformedduring tonsillectomyinpost-operativelocalpainbasedonaclinicaltria1．MethodsOnehundredcasestobeun dergonetonsillectomyweredivided intotwogroups，with50ineach，andw‘arm’orc‘old’hemostaticprocedureswereperformedtostopbleedingoccurringinthewoundduring tonsillectomyforthecasesineitherrgoupofcases．Then，thevolumeofbleedingoccurredduringtheoperationWasrecorded，hteinterval oftimelengthbeguntotakeinfoodasusualWas determniedfollownigthesurgery,andMcGillpani scoringsystem Was takentoevaluate htepost—operativepaniniawayofquestionnaireathtethirdpost—operativedayofracomparativeanalysisbetweenhtewtorgoups．Resulls Theaveragedvolumeofbleednigmeasuredduringtheoperationandtheintervallengthoftimebeguntotakeinfoodasusualwere1 0．26+0．69mlnadA comparestudyofevaluationonpaniaftertonsillectomybywarm andcoldhemostasis2．52+0．42dforhtecasesni the rgoupwiht w‘arm’hemostaticprocedures．w