扁桃腺切除術(shù)課件

Tonsillectomy扁桃腺切除術(shù)Tonsillectomy扁桃腺切除術(shù)

Background背景Oftheapproximately3.7millionENT(Ear,NoseandThroat)proceduresannually,16%,or597,000aretonsillectomyprocedures.Removalofthetonsilsortonsilsisoneofthemostfrequentlyperformedproceduresofthethroat.Most(70%)oftheTonsillectomiesareperformedonpatientsundertheageof18andoccurinahospitaloutpatientsettingorfreestandingsurgerycenter.在每年大約3.7million的兒鼻喉手術(shù)中，大約16％或597000的手術(shù)是扁桃腺切除術(shù)。扁桃腺切除術(shù)是咽喉部手術(shù)最常見的一種。大多數(shù)的扁桃腺切除術(shù)通常發(fā)生在18歲以下的病人和醫(yī)院門診病人安置處或不需要藥物的外科治療中心。Tonsillectomy

TraditionalModality一般情況Traditionally,Ear,NoseandThroat(ENT)specialistsperformTonsillectomieswithanelectrocauteryorlaserdevice.Thesurgeonsecuresthetonsilwithagrasperand,whileusinganelectrocauteryorlaserinstrument,cutstissueandcoagulatesbloodvesselssurroundingthetonsil.

一般來講，耳鼻喉科的專家用電烙術(shù)或激光裝置來行扁桃腺切除術(shù)。外科醫(yī)生用抓鉗固定扁桃腺，用電烙或激光切除扁桃腺周圍的組織和凝血。TonsilAnatomyTonsilAnatomy-

Pharyngealmucosaremoved咽部粘膜已去除Lesserpalatineartery次上鄂動(dòng)脈Tonsillarbranchoflesserpalatineartery次上顎動(dòng)脈扁桃腺分支

Tonsillarbranchofascendingpharyngealartery咽上動(dòng)脈的扁桃腺分支Palatoglossusmuscle舌顎肌Palatopharyngeusmuscle顎部肌肉Tonsillarbranchofascendingpalatineartery上顎動(dòng)脈扁桃腺分支Tonsillarbranchoffacialartery面動(dòng)脈的扁桃腺分支Tonsillarbranchofdorsallingualartery背言動(dòng)脈扁桃腺分支ENTSurgeons-

Concerns/Issues耳鼻喉科醫(yī)生關(guān)心的問題“Theprocedureisnottheproblem…postopcareistheproblem…Unscheduledphonecalls,officevisits,patientsstayinghydrated…”手術(shù)不是問題···術(shù)后的監(jiān)護(hù)才是問題···沒有規(guī)律的電話，政府的訪問，病人要口腔含水···HarmonicScalpel

ProductInformation產(chǎn)品信息TheHarmonicScalpelisintendedtocutandcoagulatesofttissue.Itisintendedtobeusedwhenbleedingcontrolandminimalthermalinjuryisdesired.Theseinstrumentscanbeusedasanadjuncttoorasubstituteforelectrosurgery,laser,andsteelscalpelsingeneral,gynecologic,ENT,thoracicsurgeryFood&DrugAdministrationClearance(USA)EESisclearedformarketingofitsHarmonicScalpeltechnologyforENTusage.(October1999)超聲刀的目的是切割和凝固軟組織。它通常應(yīng)用于當(dāng)醫(yī)生希望出血的控制和最小的側(cè)損傷時(shí)。它可以最為電刀、激光或不銹鋼手術(shù)刀的附件或替代品而應(yīng)用于普外、婦產(chǎn)、ENT和胸外科手術(shù)中。美國食品及藥品質(zhì)量監(jiān)督局已經(jīng)明確超聲刀技術(shù)在ENT中的應(yīng)用市場(chǎng)價(jià)值。TonsillectomyVideo

Lesslateralthermaldamagemaymeanlesspost-operativepharyngealpain.較小的組織側(cè)損傷意味著較小的術(shù)后咽部疼痛Bettersurgicaloutcomesmayleadtoquickerresumptionofnormalactivityandoralintake.較好的外科手術(shù)結(jié)果會(huì)導(dǎo)致較快正常組織活性的恢復(fù)和口腔飲食Decreasedcomplicationsmaymeanlessneedfo