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OBJECTIVE To analyze the varieties,causes and preventions of severe complications in OSAHS patients with delayed extubation after surgery.METHODS The clinical dates of 548 OSAHS patients with delayed extubation after surgery were retrospectively analyzed,in order to explore the incidence,reasons,and the prevention and control of severe complications.RESULTS There were 14 cases with severe complications in 548 OSAHS patients,including 1 case of septicemia,one case of nasal alar scar formation,one case of cerebral infarction,2 cases of massive hemorrhage,2 cases of tube dislocation,2 cases of ventilator resistance,2 cases of apnea,3 cases of ventilator-associated pneumonia.All of the14 cases recovered after dealing with the corresponding measures.No dead happened.CONCLUSION The incidence of complications in OSAHS patients with delayed extubation is relatively high.In order to improve the prognosis,more attentions should be paid to the airway care and manipulation in the course of treatment.When the complications happened,corresponding treatments should be done in time.If the patients' respiratory function and airway patency were normal,extubation as early as possible could reduce the incidence of complications.
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OBJECTIVE To investigate a better surgical treatment for chronic otitis media.METHODS 106 patients with chronic otitis media were collected from hospital. We assessed effectss of ossicular chain reconstruction without incision of mastoid (method 1) and ossicular chain reconstruction with incision of mastoid (method 2).We compared therapeutic effect, complication, and surgical treatment between these two groups. Furthermore, we performed stratification analysis by normal or abnormal function of stapes, Eustachian and tendon of tensor tympani, using logistic regression model. RESULTS The improvement of hearing by method 1 and 2 were 85.71%, 68.00% (P=0.0296). The recovery rate of drying ear were 92.86%, 88.00% (P=0.3931). The proportion of continued tinnitus were 10.71%, 18.00% (P=2827). There were 85.71% and 36.00% samples with numeric pain score from 1 to 3 (P<0.0001). There were 89.29%, 24.00% samples with operation hour <2.0 hour (P<0.0001). For those patients with normal function of stapes, Eustachian and tendon of tensor tympani, the OR of method 1 were 2.91, 3.08 and 3.33 For those patients with abnormal function, the OR was 3.27, 2.89 and 1.33. CONCLUSION Ossicular chain reconstruction without incision of mastoid is a suitable surgical treatment for chronic chronic otitis media,it could improve hearing more effectively with entire debridement of the focus and shorter operation time.
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OBJECTIVE@#To determine the clinical value of transoral endoscopic adenoidectomy for the pediatric sinusitis.@*METHOD@#Patients with chronic sinusitis and adenoid hypertrophy were divided into two group by undertaken with or without adenoidectomy, the operation group with 43 cases and the control group with 40 cases. Evaluation was performed in pretherapy and after 3 months therapy. Evaluation index included symptom scale for nasal obstruction and rhinorrhea, endoscopy score and CT score for chronic sinusitis.@*RESULT@#There was a positive correlation (0.38) between the adenoid size and the symptom of nasal obstruction (P 0.05). Whether in the operation group or the control group, all index scores in pretherapy were higher than in post-therapy (P < 0.05). After 3 month therapy, all index scores in the operation group were lower than the control group (P < 0.01). The decreased amplitude of all index scores in the the operation group were higher than the control group (P < 0.01).@*CONCLUSION@#Adenoidectomy combined with topical nasal treatment is one effective method for the pediatric sinusitis. Adenoidectomy play an important role in the treatment of pediatric rhinosinusitis.
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Adolescent , Child , Female , Humans , Male , Adenoidectomy , Methods , Endoscopy , Sinusitis , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To determine the clinical value of 24 h double-probe pH-metry for the diagnosis and treatment of laryngopharyngeal reflux (LPR).</p><p><b>METHODS</b>According to the pH-metry results (whether the reflux events record in the upper esophagus is more than 6.9), patients of refractory pharyngolaryngitis were divided into LPR and control groups (each of 17 cases). All patients treated with anti-acid therapy and conventional pharyngo-laryngitis therapy. Correlation between pH-metry and the reflux symptom index (RSI), the reflux symptom index (RFI) were analyzed. Changes of the RSI and RFI in different group were calculated in post-treatment.</p><p><b>RESULTS</b>In the LPR group, the median reflux events of the upright time were higher than the supine time (Z = -3.62, P < 0.01), but the difference was not discovered in the control group (Z = -0.60, P > 0.05). There was no statistical difference between RSI, RSI and RFS with pH-metry, and with moderate concordance (k were 0.47, 0.53, P < 0.01, respectively). Compared to pre-treatment, the RSI and RFI were decreased both in LPR group and control group, Amplitude decreased in LPR group significantly higher than the control groups, with statistical difference (t were 3.74, 3.01, P < 0.01, respectively).</p><p><b>CONCLUSION</b>The 24 h double-probe pH-metry is significant for the anti-acid therapy of LPR.</p>
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Adult , Female , Humans , Male , Middle Aged , Esophageal pH Monitoring , Gastroesophageal Reflux , Diagnosis , Laryngopharyngeal Reflux , DiagnosisABSTRACT
OBJECTIVE@#To explore the effect of stimulus intensity on auditory event-related potentials (AERP) evoked by tone stimuli and speech stimuli respectively.@*METHOD@#Normal young participants were tested by both tone and speech stimulus with different intensity levels. Range of the intensity for the typical AERP to tone stimuli and speech stimuli were compared. Whether the effect of intensity on,speech stimuli AERP test is the same as that of the tone stimuli were analyzed.@*RESULT@#When intensity level ranged from 40 dBSL to 70 dBSL, typical AERP were recorded more easily with speech stimuli than with tone stimuli (P < 0.01). When stimulated by speech stimuli or by tone stimuli, the latency of P300 decreased with higher intensity, the influences of intensity to P300 latency have significant difference (P < 0.01), but not to P300 peak amplitude.@*CONCLUSION@#The effect of stimulus intensity on AERP evoked by speech stimuli is the same to the tone stimuli, but intensity range for typical AERP of speech stimuli was wider than tone stimuli. It may be resulted from that information contained in speech stimulus is more abundant than that contained in tone stimulus, or subjects were more familiar with speech stimulus than tone stimulus.