Coblation Tonsillectomy Reduces Post-operative Pain and Operative Time in Adult Patients

使用冷觸氣化儀進行扁桃體切除可降低成年的術後疼痛以及手術時間

羅武嘉(Wu-Chia Lo) ； 方楷旻(Kai-Min Fang) ； 徐鵬傑(Peng-Chieh Hsu) ； 廖立人(Li-Jen Liao) ； 鄭博文(Po-Wen Cheng)

《台灣耳鼻喉頭頸外科雜誌》 51卷4期 (2016/12) Pp. 211-218

https://doi.org/10.6286/2016.51.4.211

摘要

OBJECTIVE: To compare the results between dissection tonsillectomy with bipolar hemostasis and coblation tonsillectomy. METHODS: A prospective, single-blind trial was conducted in a tertiary referral center. Forty-eight adult Taiwanese patients with chronic tonsillitis had one tonsil removed by cold steel dissection and the other one by a coblation technique. The primary outcome was pain, as determined using the visual analog scale post-operatively. Secondary outcomes were the operating time and amount of intra-operative blood loss. RESULTS: The mean pain scores were significantly lower on the coblation side from the day of operation to the third post-operative day (all p ＜ 0.05). There was no significant difference in the pain levels after the five post-operative day. The operation time and intra-operative bleeding amount were significantly less on the coblation side (both p ＜ 0.001). Post-operative bleeding was encountered in one side in each group. CONCLUSION: Coblation tonsillectomy results in a reduction of post-operative pain, operative time, and intra-operative blood loss compared to conventional dissection tonsillectomy in adult Taiwanese patients with chronic tonsillitis.

關鍵字

coblation ； tonsillectomy ； cold steel ； bipolar ； pain

並列摘要

目的：比較傳統冷刀扁桃體切除併雙極電燒止血和冷觸氣化儀扁桃體切除的結果。方法：此為在醫學中心進行之前瞻性單盲試驗。48名東方台灣成年人診斷為慢性扁桃腺炎，其中一側扁桃體接受冷刀切除而另一側接受冷觸氣化儀切除。主要成果為以疼痛視覺量表來評估之手術前後疼痛程度，次要結果為手術時間以及術中的出血量。結果：使用冷觸氣化儀該側在術後前3天的平均疼痛程度顯著較小，術後5天以後的疼痛則看不出側別的差異；使用冷觸氣化儀該側在手術時間以及術中的出血量皆顯著較少，術後出血於各組則各出現1例。結論：診斷為慢性扁桃腺炎的東方台灣成年人接受冷觸氣化儀扁桃體切除較傳統的冷刀切除可得到較少的術後疼痛以及較短的手術時間和較少的出血量。

並列關鍵字

coblation ； tonsillectomy ； cold steel ； bipolar, pain（冷觸氣化 ； 扁桃體切除 ； 冷刀 ； 雙極 ； 疼痛）