兒童門診微型切削器腺樣體切除手術安全性之評估

目的：腺樣體切除手術是小兒常見的手術，可以用來治療腺樣體肥大及漿液性中耳炎，傳統上為住院手術。為了減少醫療支出，避免病患因住院造成的影響，許多耳鼻喉科醫師開始採用門診腺樣體切除手術。本研究的目的是評估病患以門診手術方式進行微型切削器輔助經口內視鏡腺樣體切除的安全性。材料與方法：本研究針對腺樣體切除手術的病患，採回溯性的病例回顧。手術方式在全身麻醉下執行，以內視鏡搭配微型切削器施行腺樣體切除手術；病患術後在麻醉恢復室作短暫停留，並記錄手術及麻醉相關併發症的情形。結果：自2009年6月至2011年7月間，共納入46名病患（33名男童及13名女童），平均年齡為6.8歲（年齡分布為2~14歲）。大部分病患（35名）於麻醉恢復室觀察1.5小時內可離院返家；術後噁心嘔吐的病患有7名：4名發生在麻醉恢復室，3名在離院返家後發生；所有病患術後皆無出現出血、上呼吸道阻塞或發燒等情形；所有病患在手術隔天都能正常飲食。結論：以微型切削器輔助經口內視鏡腺樣體切除是安全可行的小兒門診手術。

關鍵字

腺樣體切除手術；門診手術；安全性；微型切削器

並列摘要

OBJECTIVES: Adenoidectomy is a common pediatric surgery that is used to treat adenoid hypertrophy and/or otitis media with effusion, and is traditionally done on an inpatient basis. To reduce health care expenses and avoid the impact of hospitalization, many ENT surgeons have started to perform outpatient adenoidectomy. The purpose of the current study was to evaluate the safety of outpatient pediatric adenoidectomy using a microdebrider.METHODS: A retrospective chart review of children who had undergone outpatient adenoidectomy was performed. The procedure was carried out under general anesthesia, and the adenoid tissue was removed by microdebrider under endoscopic guidance. The patients were observed in the recovery room, and the occurrence of complications pertaining to the surgery and anesthesia were recorded.RESULTS: Forty six patients (33 boys and 13 girls) were included in the study, which ran from June 2009 to July 2011. The mean age of the patients was 6.8 years (range, 2 to 14). Most of the patients (35 out of 46) were discharged home in 1.5 hours. Postoperative nausea and vomiting occurred in seven patients (four in the recovery room and three at home). There was no bleeding, upper airway obstruction or fever postoperatively. Oral intake for all patients became normal on the following day.CONCLUSIONS: Pediatric adenoidectomy by microdebrider can be safely performed on an outpatient basis.

並列關鍵字

adenoidectomy ； outpatient surgery ； safety ； microdebrider

國際替代計量

兒童門診微型切削器腺樣體切除手術安全性之評估

全文下載

主題瀏覽