Hot Versus Cold Tonsillectomy: A Systematic Review of the Literature
Hot Versus Cold Tonsillectomy: A Systematic Review of the Literature
复制标题
热扁桃体切除术与冷扁桃体切除术：文献的系统回顾
DOI：
10.1016/s0194-59980300729-0
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
Sandra Y. Lin
中科院分区：
文献类型：
--
作者：
R. Leinbach;S. Markwell;J. Colliver;Sandra Y. Lin
目的：系统回顾比较单极电灼术与冷刀扁桃体切除术的文献。方法：应用计算机检索MEDLINE数据库，检索词“扁桃体切除术”、“热”、“冷”、“尖”、“出血”和“烧灼”。选择标准包括比较电刀剥离和冷刀剥离对扁桃体切除术后疼痛和出血的前瞻性试验。结果：配对研究的汇总数据显示，术后4~10天，电切侧疼痛程度明显高于冷刀侧(33/293，11%；P=0.001)。电切组术后止痛量明显增加(平均26.7vs19.2；P=0.028)，成人电切组疼痛评分较高(平均2.6vs0.8；统计学意义无法确定)。两组的出血率没有差异。结论：与扁桃体切除的锐性剥离相比，电剥脱术增加了疼痛。术后出血率比较，两种方法差异无统计学意义。(《耳鼻喉科头颈外科》2003；129：360-4)
OBJECTIVE:We systematically reviewed the literature comparing monopolar electrocautery versus cold knife dissection tonsillectomy.METHODS:The MEDLINE database was searched using the key words “tonsillectomy,” “hot,” “cold,” “sharp,” “bleeding,” and “cautery.” Selection criteria included prospective trials comparing electro-dissection versus cold knife dissection on posttonsillectomy pain and hemorrhage. Six of the 815 articles met the selection criteria.RESULTS:Pooled data for the paired studies showed significantly more patients with pain worse on the electrodissection side (148 of 293 = 51%) than the cold knife side (33 of 293 (11%);P= 0.001) on postoperative days 4 to 10. There were significantly more analgesic doses after surgery with electrodissection (means 26.7 versus 19.2;P= 0.028) and higher pain scores for adults undergoing electrodissection (means, 2.6 versus 0.8; significance could not be determined). There were no differences in hemorrhage rates.CONCLUSIONS:Electrodissection increases pain in comparison to sharp dissection for tonsillectomy. Postoperative hemorrhage rates are not significantly different when comparing the 2 methods. (Otolaryngol Head Neck Surg 2003;129:360–4.)