ABSTRACT
Objective To investigate the effect of anti-bleeding gauze (TISTAT) in nasal packing after endoscopic sinus surgery in elderly patients.Methods 72 elderly patients with chronic sinusitis and nasal polyps for endoscopic sinus surgery were divided into two groups:TISTAT group (use TISTAT,n=38) and calcium alginate group(use calcium alginate,n=34).TISTAT and calcium alginate were respectively used as packing materials in TISTAT and calcium alginate group.Hemorrhage in the packing process and after the packing materials removed were observed and compared.The symptoms such as headache、nasal blockage and nose pain during the packing process and 24 hours after the packing materials removed were compared.The recovery of surgery cavity in 4 weeks after surgery which reviewed once a week were checked and compared.Results The tamponade during hemorrhage rates of TISTAT group and calcium alginate group were 31.6％ (12 cases)、58.5％ (20 cases),after removing the tamponade,the total bleeding rates were 15.8％,41.2 ％,two groups had significant difference (P＜0.01) ;TISTAT group nasal pain symptoms in the packing process,packing materials were 12 h,stuffing out after 24 h were (2.8±0.6)、(1.3±0.5),calcium alginate group nasal pain symptoms in the packing process,packing materials were 12 h.stuffing were 24 h were (5.2±0.4)、(4.3±0.6),two groups of nasal pain symptom difference was statistically significant (P＜0.05),but the process of tailing and calcium alginate group blocked nose were (5.4±0.9) 、(8.3±0.6),the two groups had significant difference (P＜0.05).Conclusions The anti-bleeding gauze(TISTAT) has safety and active role in nasal packing after endoscopic sinus surgery in elderly patients with less symptoms and a better surgical cavity recovery.It is an ideal packing material.
ABSTRACT
Objective To analyze the clinical diagnosis and treatment of pediatric tracheo-bronchial foreign body cases and therapeutic effects. Methods A retrospective review of the clinical manifestations, the feature of ima- geology and the methods of removing foreign body of 120 cases of pediatric tracheobronchial foreign body, which were confirmed with tracheobronchial foreign body by direct laryngoscope or rigid bronchoscope. Results History of aspiration was present in 90.8 % (109/120) of all cases, penetration syndrome was present in 100 % (120/120) of all cases. Among 39 cases with tracheal foreign body, there were 26 cases with audible flapping sound in trachea, the fre- quency was 66.7 %. With the X-ray chest fluoroscopy showing media-stinal swaying,59 cases were confirmed to be with foreign body by bronchoscope. The accurate rate of diagnosing traeheobronehial foreign body via CT was 86.2 % (25/29). All cases were confirmed and treated by direct laryngoscope and rigid bronchoscope. The foreign bodies of 119 cases were successfully removed. 1 patient was turned into the department of chest surgery. Conclusion History of aspiration, penetration syndrome, audible flapping sound in trachea, X-ray chest fluoroscopy showing mediastinal swaying are important evidence in diagnosing tracheobronchial foreign body. The accurate rate of diag- nosing tracheobronchial foreign body via chest CT is relatively high. Direct laryngoscope and bronchoscopy are con- firming methods in diagnosing tracheobronehial foreign body; it is effective methods to remove traehco-bronchial for- eign body by direct laryngoscope and rigid bronchoscope.