The curative effect analysis of balloon sinuplasty and the main points of its use / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of this study was to evaluate the safety and effectiveness of balloon sinuplasty, and to summarize the main points of its use.@*METHOD@#Fifteeen patients (41 sinuses) were offered treatment with a new technique of balloon sinuplasty and followed for 3 to 6 months after surgery, including "balloon-only" patients and "hybrid" patients. Effectiveness was evaluated by endoscopic examination and computed tomographic (CT) scan. The effect of the operation was tested by the Lund-Mackay CT scores, and the patient's subjective symptoms were tested by the sino-nasal outcome test-20 (SNOT-20) to evaluate postoperative condition.@*RESULT@#Fifteeen patients (41 sinuses) were followed after surgery, including 9 "balloon-only" patients and 6 "hybrid" patients. No unanticipated adverse effects were noted in any patients. Endoscopic examination showed the sinus ostium was opening well, and CT scan showed the lesions apparently disappeared. Lund-Mackay CT scores showed that all patients postoperative scores were significantly improved from baseline at 3 months and 6 months. SNOT-20 showed that all patients postoperative scores were significantly improved from baseline at 3 months and 6 months. There was no significant difference between the "balloon-only" patients and "hybrid" patients. Operation curative effect is very confirmed, and subjective symptoms improved significantly.@*CONCLUSION@#Balloon sinuplasty can not only open nasal sinus effectively, but also preserve normal tissue structure and mucous membrane of nasal cavity and nasal sinus. Balloon sinuplasty appears to be a safe, effective and minimally invasive treatment option to relieve sinus ostial obstruction. Patients who received balloon catheter sinusotomy in endoscopic sinus surgery had significant improvement after surgery. Balloon sinuplasty can also be combined with the endoscopic sinus surgery to achieve a better therapeutic effect. It is worth of clinical promotion and application.

The retrospective analysis of 61 patients with ventilator-associated pneumonia / 中国基层医药

Objective To retrospectively analyze risk factor and outcome of VAP after treatment.Methods To retrospectively analyze the incidence of VAP in 249 patients accepted mechanical ventilation.Results Logistic regression analysis shew that age,APACHE Ⅱ scores,the time of mechanical ventilation,gastric acid secretion inhibitor therapy,conscious disturbance,combinations of antibiotics,stomach catheter insertion were associated risk factors for ventilator-associated pneumonia.A total of 91 pathogenic bacterium were identified.G pathogenic bacteriums accounted for 80.2% and G~+ pathogenic bacteriums accounted for 18.6% and true fungus accounted for 1.2%.Multidrug resistance was in most pathogenic bacteriums.All patients were treated with sensitive antibiotics and 39 cases were cured(63.9 %)and 22 cases were dead(36.1 %)after 2-6 weeks treatment.Conclusion Existence of risk factors of VAP are correlated with risk factor and G-pathogenic bacteriums are major pathogenic bacteriums and common drug resisitant microorganisma lead to bad outcome.