基层医院应用双极电凝镊辅助扁桃体切除术的临床观察

doi:10.11958/20252095

天津医药 ›› 2026, Vol. 54 ›› Issue (1): 74-78.doi: 10.11958/20252095

基层医院应用双极电凝镊辅助扁桃体切除术的临床观察

贾岩峰¹(), 王营¹, 牟玉霞², 刘雅莉², 刘子健², 杨相立¹^,^△()

1 天津市人民医院（南开大学附属第一医院）耳鼻咽喉头颈外科（邮编300121）
2 甘肃省甘南藏族自治州人民医院五官科

收稿日期:2025-05-26 修回日期:2025-09-22 出版日期:2026-01-15 发布日期:2026-01-19
通讯作者: ^△ E-mail：yangxiangli@163.com
作者简介:贾岩峰（1979），男，副主任医师，主要从事耳鼻咽喉科基础与临床方面研究。E-mail：yanfengmaster@163.com

The clinical observation of bipolar electrocoagulation forceps assisted tonsillectomy in primary hospital

JIA Yanfeng¹(), WANG Ying¹, MOU Yuxia², LIU Yali², LIU Zijian², YANG Xiangli¹^,^△()

1 Department of Otolaryngology Head and Neck Surgery, Tianjin Union Medical Center (The First Affiliated Hospital of Nankai University), Tianjin 300121, China
2 Department of Otolaryngology, Gannan Tibetan Autonomous Prefecture People's Hospital

Received:2025-05-26 Revised:2025-09-22 Published:2026-01-15 Online:2026-01-19
Contact: ^△ E-mail：yangxiangli@163.com

贾岩峰, 王营, 牟玉霞, 刘雅莉, 刘子健, 杨相立. 基层医院应用双极电凝镊辅助扁桃体切除术的临床观察[J]. 天津医药, 2026, 54(1): 74-78.

JIA Yanfeng, WANG Ying, MOU Yuxia, LIU Yali, LIU Zijian, YANG Xiangli. The clinical observation of bipolar electrocoagulation forceps assisted tonsillectomy in primary hospital[J]. Tianjin Medical Journal, 2026, 54(1): 74-78.

摘要/Abstract

摘要：

目的探讨在基层医院应用双极电凝镊辅助扁桃体切除术的临床效果。方法回顾性选取行扁桃体切除术患者82例，其中40例患者接受传统的扁桃体剥离术治疗（对照组），另外42例接受双极电凝镊辅助扁桃体切除术治疗（观察组）。收集2组的手术时间、术中出血量，术后白膜脱落时间、并发症情况、住院时间及住院费用，采用疼痛视觉模拟量表（VAS）评分记录扁桃体切除术后1、3、7 d患者咽部的疼痛情况。结果与对照组比较，观察组手术时间较短，出血量较少，但白膜脱落时间较长，术后1、3、7 d疼痛VAS评分更低（P<0.01）。2组患者的住院时间比较差异无统计学意义，观察组住院费用高于对照组（P<0.01），2组继发出血、创面感染及咽部水肿等并发症总发生率比较差异无统计学意义。结论双极电凝镊辅助扁桃体切除术具有手术时间短、术中出血少、术后疼痛轻、费用易接受等优点，适合在基层医院或经济欠发达地区应用。

关键词: 扁桃体切除术, 出血, 疼痛, 住院时间, 双极电凝, 基层医院

Abstract:

Objective To explore the clinical efficacy of using bipolar electrocoagulation forceps to assist tonsillectomy in primary hospital. Methods Clinical data of 82 patients who underwent tonsillectomy in Department of Otolaryngology, Gannan Tibetan Autonomous Prefecture People's Hospital from November 2022 to November 2024 were collected and retrospectively analyzed. According to different tonsillectomy methods, patients were randomly divided into the control group (n=40) and the observation group (n=42). Patients in the control group were treated with traditional tonsillectomy, and patients in the observation group were treated with bipolar electrocoagulation forceps assisted tonsillectomy. Data regarding operation duration, intraoperative blood loss, postoperative white membrane shedding time, complications, length of hospital stay and hospitalization costs were collected for both groups. The Visual Analogue Scale (VAS) was employed to assess pharyngeal pain on the postoperative day 1, 3 and 7 following tonsillectomy. Results Compared with the control group, the observation group exhibited a shorter operative duration and reduced intraoperative blood loss, although the time to white membrane detachment was prolonged. The VAS scores on the postoperative day 1, day 3 and day 7 were significantly lower in the observation group (P<0.01). There was no significant difference in length of hospital stay between the two groups. However, the overall hospitalization cost was higher in the observation group (P<0.01). There were no significant differences in the incidence of complications such as secondary hemorrhage, wound infection, or pharyngeal edema between the two groups. Conclusion Bipolar electrocoagulation forceps assisted tonsillectomy has the advantages of short surgical time, less intraoperative bleeding, mild postoperative pain and easy cost bearing. It is suitable for application in primary hospital or economically underdeveloped areas.

Key words: tonsillectomy, hemorrhage, pain, length of stay, bipolar electrocoagulation, primary hospital

中图分类号:

R766.9

图/表 4

参考文献 22

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组别	n	手术时间/min	出血量/mL	白膜脱落时间/d
对照组	40	38.98±5.10	12.00±2.68	7.23±1.37
观察组	42	28.29±6.06	7.67±2.90	9.05±2.00
t		8.621^＊＊	7.016^＊＊	4.837^＊＊

组别	n	手术时间/min	出血量/mL	白膜脱落时间/d
对照组	40	38.98±5.10	12.00±2.68	7.23±1.37
观察组	42	28.29±6.06	7.67±2.90	9.05±2.00
t		8.621^＊＊	7.016^＊＊	4.837^＊＊

组别	n	术后1 d	术后3 d	术后7 d
对照组	40	6.08±0.94	3.85±0.86	1.88±0.82
观察组	42	4.36±0.78	2.64±0.58	1.14±0.57
t		9.099^＊＊	7.475^＊＊	4.674^＊＊

组别	n	术后1 d	术后3 d	术后7 d
对照组	40	6.08±0.94	3.85±0.86	1.88±0.82
观察组	42	4.36±0.78	2.64±0.58	1.14±0.57
t		9.099^＊＊	7.475^＊＊	4.674^＊＊

组别	n	住院时间/d	住院费用/元
对照组	40	6.53±1.41	4 607.90±273.87
观察组	42	6.57±1.71	5 396.83±306.69
t		0.133	12.265^＊＊

基层医院应用双极电凝镊辅助扁桃体切除术的临床观察

The clinical observation of bipolar electrocoagulation forceps assisted tonsillectomy in primary hospital

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组别	n	继发出血	创面感染	咽部水肿	合计
对照组	40	2（5.00）	1（2.50）	2（5.00）	5（12.50）
观察组	42	0（0.00）	1（2.38）	2（4.76）	3（7.14）
χ²					0.198

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