钟　权　唐　锐

【摘要】 目的 探讨经口鼻内窥镜辅助行小儿腺样体刮除术与传统的腺样体刮匙切除术两种术式的疗效,术后残留或复发率高低及其优劣。方法 64例患儿随机分为观察组(33例)和对照组(31例),观察组采用经口鼻内窥镜辅助行小儿腺样体刮除术。对照组用传统的腺样体刮匙切除术切除腺样体,随访3个月~1年,比较两组治疗总有效率及术后残留或复发率高低。结果 观察组与对照组治疗总有效率分别为96．9%和90．3%,两组比较,差异无显著意义(x=2．25P>0．05)。观察组与对照组术后残留或复发率分别为9．1%和41．9%,两组比较,差异有显著意义(x=9．2P<0．05)。结论 经口鼻内窥镜辅助行小儿腺样体刮除术直观,术野清晰,手术彻底,术后残留或复发率低,值得推广。

【关键词】内窥镜；腺样体；手术；外科

The clinical research about transoral endoscopic-assisted adenoidectomy for children

ZHONG Quan，TANG Rui.Department of Otorhinolaryngology,Peoples Hospital of Guangxi,541002 China

【Abstract】 Objective To discuss the effects of transoral endoscopic-assisted adenoidectomy for children and traditional adenoidectomy.the remains or the rafe of recurrence and the good and the bad about it after the operation.Methods Sixty-four sick children were divided into an experimentral group(n=33)and a control group(n=31),the experimentral group were performed the trasoral endoscopic-assisted adenoidectomy for children,the control group were performed the traditional adenoidectomy,all cases were following up 3 months to one year,comparethe totel therapeutic effective rates and the remains or the height of recurrence after the operation.Results Total effective rates of the two groups were 96．9% and 90．3%,respectively,with no significant difference found between the two groups(x=2．25 P>0．05),the remains or the rate of recurrence between the experimentrol group and the control group were 9% and 41．9%,respectively,with a significant difference found between the two groups(x=9．2 P<0．05).Conclusion The transoral endoscopic-assisted adenoidectomy for children has the adventage of direct,clear and open visualization,thorough curetting adenoid or low rate of recurrence worthspead.

【Key words】Endoscopic;Adenoids;Surgery；Operative

腺样体肥大和扁桃体肥大是引起小儿鼾症的主要原因，对儿童的智力及骨髓发育有一定影响，如身材矮小，智商较低。部分小儿会出现面部表情呆滞，面型窄长，硬腭高拱，牙列不齐，上颌弓狭窄，上下切牙外倾，下颌后缩等腺样体面容。彻底解决腺样体肥大最有效的方法是手术切除。我科对经口鼻内窥镜下小儿腺样体切除术与传统腺样体刮匙切除术进行比较,报告如下。

1 资料与方法

1．1 临床资料 本组64例。男35例，女29例，年龄4~7岁，平均5．4岁，病程2~5年。主要表现：持续性鼻塞伴睡眠打鼾或张口呼吸，伴脓涕，伴反复咽痛及发热。其中47例均经纤维鼻咽镜检查及鼻咽侧位片检查显示腺样体肥大堵塞鼻后孔，呼吸道狭窄。17例患儿因不配合纤维鼻咽镜检查，只做鼻咽侧位片检查显示：腺样体明显肥大，呼吸道狭窄。所有病例随机分为2组：观察组33例,对照组31例，两组年龄、性别、病程及病情比较，差异无显著性意义(均P>0．05)。