Clinical Study Of Low-temperature Plasma Radiofrequency Ablation Of Adenoids

Research objectives:The purpose of this study is to analyze the surgical effect of two kinds of plasma electrode for adenoidectomy,and to explore the surgical method and range of adenoidectomy,so as to select a more appropriate plasma electrode and find a better surgical method for adenoidectomy.Research Methods:The patients with adenoid hypertrophy who met the inclusion criteria in the Second Affiliated Hospital of University of south China were selected from July1,2019 to August 31,2020.According to different surgical approaches,the patients were randomly divided into a combined oral and nasal adenoidectomy group(the combined group)and a simple oral adenoidectomy group(the oral group).At the same time,The patients were divided into MC401 group(using meichuang 401 disposable plasma radiofrequency ablation electrode)and MC404 group(using meichuang 404 disposable plasma radiofrequency ablation electrode)according to the difference of two kinds of plasma knife used in the operation.All the operations were performed by the deputy senior and above professional doctors.By comparing the intraoperative electrocoagulation hemostasis,intraoperative eustachian tube pillow and pharyngeal mouth injury,operation time,intraoperative cutter head blockage times,preoperative and postoperative children OSAHS specific quality of life survey(OSA-18)score and symptom score,postoperative electronic laryngoscope observation of adenoid hyperplasia.All data were statistically analyzed according to data type using SPSS 25.0 software,and P < 0.05 was considered statistically significant.Results:213 cases were included in this study,including 135 males and 78 females;118 cases were in combination group,73 males and 45 females;95 cases were in oral group,62 males and 33 females.There were 73 males and 40 females in MC401 group and 62 males and 38 females in MC404 group.All the data was statistically analyzed by SPSS 25.0 software.When P < 0.05,statistical difference was considered.Analysis of the operation group(MC401/ MC404):(1)there were no significant differences in age,gender,course of disease,hypertrophy grade and surgical approach between the two groups(P > 0.05),which were comparable;(1)In terms of surgical efficiency: operation time,electrode blockage and intraoperative electrocoagulation,the operative time,electrocoagulation hemostasis and electrode blockage times in MC401 group were all higher than those in MC404 group(P < 0.05);(1)Analysis of surgical complications(intraoperative eustachian tube occipital injury and postoperative odor emission): the injuries of eustachian tube occipital injury and postoperative odor emission in MC401 group were both higher than those in MC404 group(P< 0.05);(1)In terms of surgical effect analysis,there was a statistically significant difference in the improvement degree of postoperative OSA-18 score between the two groups(P < 0.01).The difference analysis of the improvement degree of postoperative OSA-18 score between the two groups showed that the improvement degree of MC401 group was greater.The improvement degree of postoperative symptom scores between the two groups was statistically significant(P < 0.01).Symptomatic scores of the two groups showed differences in open-mouth breathing,nasal congestion and snoring before surgery,but no statistical difference was found in runny nose(P > 0.05);(1)The data of 111 patients with postoperative fibrous nasal endoscopy were analyzed,including 55 patients in MC401 group and 15 patients with residual hyperplasia,56 patients in MC404 group and 10 patients with residual hyperplasia.The P value of > 0.05 was not statistically significant.Analysis of surgical approach(combined group/ oral group):(1)there were no significant differences in age,gender,course of disease,hypertrophy grade and plasma knife between the two groups(P > 0.05),which were comparable;(1)The preoperative and postoperative OSA-18 scores and symptom scores were significantly decreased in the two groups(P < 0.01);there was no significant difference in the preoperative and postoperative surgical effect between the two groups(P > 0.05);(1)There were no statistical differences in the electrocoagulation hemostasis,the injury of the eustachian tube round pillow and the frequency of electrode blockage between the two groups(P > 0.05).(1)The results of 111 cases were analyzed,including 63 cases in the combination group,4 cases in the oral group,and 21 cases in the oral group.The results showed that there was significant difference in the residual hyperplasia between the two groups(P < 0.01).Conclusion:(1)Plasma adenoidectomy is an excellent surgical method for adenoidectomy,which is highly effective whether combined approach or oral approach,or MC401 or MC404.(2)The MC404 electrode is relatively effective and safe during surgery.(3)Compared with MC401,MC404 can significantly shorten the operation time,reduce the occurrence of intraoperative complications,and has better operation efficiency and safety.