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一个随机的临床试验的腹腹治疗比较排水和桃体切除术
François Voruz1, Rebecca Revol1, Maxime Mermod1
1Department of Clinical Neurosciences, Clinic of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, University of Geneva, 1211, Geneva, Switzerland.
桃体腹 (PTA) 的立即桃体切除术提供了更高的成功,但增加了出血风险. 在局部麻醉下排水不那么有效,更痛苦,虽然更安全. 患者的因素指导治疗选择.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 头部和部手术 头部和部手术
- 紧急医疗 紧急医疗
背景情况:
- 腹 (PTA) 管理需要仔细考虑治疗方式.
- 一项随机临床试验 (NCT04543708) 研究了成人无并发单边PTA的两个主要治疗方法.
研究的目的:
- 为了比较即时桃体切除术的疗效,安全性和耐受性与在局部麻醉下排水用于治疗单侧外桃桃 (PTA) 的疗效,安全性和耐受性.
主要方法:
- 一项随机对照试验,涉及41名成年患者,放射学证实PTA (≥1厘米).
- 参与者被随机分配在全身麻醉下进行即时桃体切除术或在局部麻醉下进行排水.
- 主要结局是48小时治疗成功,通过减少胀和恢复吞功能来定义.
主要成果:
- 立即桃切除术的成功率达到100%,远高于排水的75%成功率 (p=0.02).
- 排水组的疼痛和焦虑水平显著增加 (p<0.01).
- 术后出血发生在桃体切除组的33%,在排水组没有出血 (p<0.01).
结论:
- 立即的桃切除术提供了具有高疗效的PTA的最终治疗方法,但具有更高的术后出血风险.
- 在局部麻醉下排水效果较差,并引起更多的患者不适,但在出血方面提供了更好的安全性.
- 治疗决策应根据患者的偏好,临床状况和资源的可用性进行个性化.
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