国内扁桃体切除术方法应用状况的调查

Investigation on techniques applied to tonsillectomy in China

摘要:

目的通过对国内扁桃体切除术方法的调查，了解国内扁桃体切除术方法的应用状况，以推动该领域技术方法的合理应用。方法通过电话、面询或电子邮件等方式对广西（省内组）和国内其他21个省市（省外组）共82家地市级以上的医院进行扁桃体切除术方法的调查，对获取数据进行统计分析与比较。结果目前国内使用的扁桃体切除方法有剥离法、挤切法、单极电刀法、等离子法、激光法、超声刀法6种。省外组6种方法全部采用，其中单独使用最多的方法是剥离法（25%），73.1%医院使用冷切法，67.3%医院使用热切法。省内组使用的方法有单极电刀法、等离子法、剥离法、超声刀法4种，单独使用最多的方法是单极电刀法（46.7%）；无医院单独使用冷切法，100%医院使用热切法。与省外组相反，省内组单独使用以及总体使用情况，热切法均高于冷切法。结论国内目前扁桃体切除术方法无论是单独使用还是总体使用情况，冷切法均高于热切法。应积极推广紧跟国际先进走向。

关键词:扁桃体切除术| 单极电刀法| 热切法| 调查| 教学

Abstract:

ObjectiveTo figure out the status of techniques applied to tonsillectomy via investigation on surgical methods adopted in domestic hospitals for promoting proper use of the techniques.MethodsSurgical methods for tonsillectomy adopted in 82 hospitals of prefecturelevel cities or above distributed among Guangxi Zhuang Autonomous Region (provincial group) and other 21 domestic cities and provinces (outsideprovince group), were investigated through ways such as telephone calls, face to face consultation and email. All data were statistically analyzed.ResultsAt present, a total of 6 techniques were used for tonsillectomy in domestic hospitals, including stripping, guillotine, monopolar electrosurgery, coblation, laser dissection and harmonic scalpel. In the hospitals of outsideprovince group, all the 6 techniques were used and stripping method was most widely singly used (25%). Cold cutting surgery was used in 73.1% of the hospitals and thermal surgery in 67.3%. As in Guangxi Zhuang Autonomous Region (provincial group), monopolar electrosurgery, coblation, stripping and harmonic scalpel were used. The most widely singly used technique was monopolar electrosurgery (46.7%). Cold cutting methods were no longer singly used in any of the surveyed hospitals of the provincial group. Thermal surgery was used in all the hospitals. Contrary to the outsideprovince group, thermal surgery was more widely used than cold surgery in the provincial group, no matter in singly use or overall uses.ConclusionsThe domestic application of techniques for tonsillectomy is relatively confused, and cold surgery is more widely used than thermal surgery in both singly and overall uses. Our domestic general situation lags behind the international mainstreams. Actively promoting application of advanced techniques may guide it to keep up with the international trends. And mainstream guidelines such as textbooks should play important roles in promoting the techniques’ application.

Key words:Tonsillectomy|Unipolar electric knife| Thermal surgery| Investigation|Teaching method