Résumé
Objective@#To explore the efficacy of closed negative pressure irrigation and suction device (Patent number: Z200780013509.8) in the treatment of high perianal abscess.@*Methods@#From January 2015 to December 2016, ≥18-year-old patients with primary high perianal abscess who were treated at our department were prospectively enrolled. Exclusion criteria: (1) recurrent perianal abscess; (2) complicated with anal fistula formation; (3) preoperative, intraoperative or postoperative physical therapy, and curettage treatment, negative pressure irrigation; (4) Crohn′s disease-related perianal abscess; (5) with immunosuppressive status, such as transplant recipients; (6) co-existence of malignant tumors, such as leukemia; (7) with diabetes; (8) those who could not receive long-term follow-up and were not suitable to participate in this study. According to the random number table method, the patients were randomly divided into negative pressure irrigation and suction group and routine drainage group. All patients were clearly diagnosed and the location and size of the perianal abscess were marked before surgery. These two groups were treated as follows: (1) Negative pressure irrigation and suction group: the skin was incised at a diameter of 1-2 cm at the site where the abscess fluctuated most obviously. After the abscess was removed, a closed negative pressure irrigation and suction device was installed and the pressure of -200 to -100 mmHg (1 mmHg=0.133 kPa) was maintained to keep the abscess cavity collapsed. Generally, the irrigation was stopped 5 days later or when the drainage was clear. The closed vacuum suction was maintained for 2 additional days, before the wound was sutured. (2) Conventional drainage group: conventional incision and drainage was carried out. The skin was cut at a diameter of 8 to 10 cm at the site of abscess with most obvious fluctuation. After the abscess was removed, normal saline gauze was used for dressing. Dressing was changed regularly until the wound healed. The efficacy, operative time, intraoperative bleeding, incision length, frequency of dressing change, pain index (visual analogue score, VAS score), postoperative healing time, complications, recurrence rate of perianal abscess, anal fistula formation rate were observed. The t test and χ2 test were used for comparison between the 2 groups.@*Results@#There were both 40 patients in the negative pressure irrigation and suction group and the conventional drainage group. There were 28 males and 12 females in negative pressure irrigation and suction group with a mean age of (38.3±12.0) years and mean disease course of (6.6±2.1) days. The abscess in pelvic-rectal space accounted for 50.0% (20/40) and the mean diameter of abscess was (8.0±3.7) cm. There were 26 males and 14 females in the conventional drainage group with a mean age of (37.1±11.8) years and mean disease course of (6.4±2.5) days. The abscess in pelvic-rectal space accounted for 55.0% (22/40) and the diameter of abscess was (8.2±3.5) cm. The differences in baseline data between two groups were not statistically significant (all P>0.05). Both groups successfully completed the operation. There was no significant difference in operative time between two groups (P>0.05). As compared to conventional drainage group, intraoperative blood loss in negative pressure irrigation and suction group was less [(12.1±5.5) ml vs. (18.3±4.4) ml, t=5.606, P<0.001], incision length was shorter [(2.3±0.8) cm vs. (7.6±1.7) cm, t=17.741, P<0.001], postoperative VAS pain scores at 1-, 3-, 7-, and 14-day after operation were lower [3.7±1.4 vs. 7.6±1.8, t=10.816, P<0.001; 3.0±1.3 vs. 6.8±1.6, t=11.657, P<0.001; 2.7±0.9 vs. 5.1±1.1, t=10.679, P<0.001; 1.2±0.3 vs. 1.6±0.4, t=5.060, P=0.019], the dressing change within 7 days after operation was less (3.5±1.2 vs. 12.6±2.7, t=19.478, P<0.001), postoperative healing time was shorter [(10.4±3.0) d vs. (13.5±3.8) d, t=4.049, P<0.001] and postoperative complication rate was lower [17.5% (7/40) vs. 2.5% (1/40), χ2=5.000, P=0.025]. During follow-up of 12 to 36 (24±5) months, the recurrence rate of perianal abscess within 1 year after operation and anal fistula formation rate in negative pressure irrigation and suction group were lower than those in conventional drainage group [5.0% (2/40) vs. 20.0% (8/40), χ2=4.114, P=0.042 and 2.5% (1/40) vs. 17.5% (7/40), χ2=5.000, P=0.025, respectirely]. The one-time cure rate of negative pressure irrigation and suction group and conventional drainage group was 92.5% (37/40) and 62.5%(25/40), respectirely (χ2=10.323, P=0.001).@*Conclusions@#The application of the negative pressure irrigation and suction device in the treatment of high perianal abscess can improve the efficiency of one-time cure, reduce postoperative pain, accelerate healing time, decrease the morbidity of postoperative complication and the rates of abscess recurrence and anal fistula formation, indicating an improvement of the treatment.
Résumé
Objective To improve the success rate of cerebrospinal fluid (CSF) collection in rats using a modified suction device with negative pressure. Methods A flow regulator was added to the original apparatus to adjust the intensity of negative pressure and to limit the volume of CSF collected each time. A total of 36 male Sprague- Dawley (SD) rats were randomly divided into 3 groups, and the CSF was collected in 3 ways: drawing from the cerebellomedullary cistern via percutaneous puncture, using a suction device with negative pressure and using a modified device. Kruskal-Wallis test was used to evaluate the differences in result between these three methods. Results The modified suction device with negative pressure effectively reduced bleeding. The quality of CSF collected with it was 75％ of 12 rats, significantly higher than that obtained with the original device (33. 3％, P ＜ 0. 01) or drawn from the cerebellomedullary cistern via percutaneous puncture (0％, P ＜ 0. 001). The success rate of qualified sample collection was highly superior to those of previously reported CSF collection methods. Conclusions Our modified suction device for CSF collection is simple and user-friendly, with minimal damage and little bleeding to rats. It can obviously improve the success rate of CSF collection in rats.
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Objective To investigate the efficacy and safety,as well as surgical essentials of upper urinary tract calculi (calculi being≤2 cm in diameter) complicated with pre-surgical uncertain pyonephrosis through one-stage renal calculi removal by percutaneous nephrolithotomy and suction device.Methods Retrospective analysis was used to detect the thirty-three cases with upper urinary tract calculi complicated with pre-surgical uncertain pyonephrosis collected from August 2010 to March 2016 in Yellow River Sanmenxia Hospital Affiliated to Henan University of Science and Technology,all the cases in the group had no pre-surgical fever,no apparent infection by blood-urine routine test,different degrees of hydronephrosis and no indications of pyonephrosis confirmed by CT and color Doppler ultrasonography,no pre-surgical anti-infection cure,pyonephrosis was found during the operation.First of all,a suction device was used to suck pus through percutaneous renal channel,rinsing repeatedly with small amount of fluid until the sucked rinsing fluid was clear;then,the one-stage calculi was removed by percutaneous renal lithotripsy,and the pus was sent to be cultured during the surgery,and the cases were treated by postoperative intravenous anti-infection for seven to seventeen days.Operation condition,postoperative blood routine,temperature,calculi removal and other clinical recovery conditions should be carefully observed.Results All the 33 cases underwent the one-stage single channel percutaneous nephrolithotom,the surgery was successful,the operation lasted 28-59 minutes,with an average of 41 minutes per case.Within the first-week of operation,CT reexamination showed the stone-free rate was 90.9% (30/33),and three cases had residual stone,the maximum diameter was about 6mm;seven cases had high fever within 3 days after the surgery (21.2%),and the temperature in four cases was higher than 38.5℃(12.1%) and two cases had fever within 3-6 days after surgery (6.1%),the highest temperature reached 38.0℃,and no fever existed after 6 days.Compared with preoperative values,the postoperative blood routine indicated that the surgery-relevant hemoglobin has decreased to (6.16±5.21) g/L;three days after surgery,white blood cell count was (7.16±4.86) 109/L.There were no severe complications such as sepsis,septic shock,renal abscess,hemorrhage.All cases were followed up for 6 to 36 months and no secondary pyonephrosis or renal dysfunction occurred during that period.Conclusion The treatment of upper urinary tract calculi,complicated with pyonephrosis without pre-surgical fever through one-stage renal calculi removal by percutaneous nephrolithotomy and suction device is effective and safe,it can be used as the routine method in basic hospitals and more attention should be paid to the operation and renal pelvic pressure in order to avoid the occurrence of complication.
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Objective To study the technique and clinical effect of endoscopic surgery using high frequency electrotome with suction device for nasopharyngeal angiofibroma. Methods In this study, we retrospective analyzed the clinical data of 10 patients treated between January 2009 and December 2015. All these patients were treated by endoscopic surgery using high frequency electrotome with suction device. The average blood loss during surgery, tumor residual, recurrent tumor and duration of recovery were evaluated. Results The tumor was completely removed in all 10 patients. The average blood loss was 465 ml, there was no postoperative complication, all patients had no residual tumor, and there was no recurrent tumor over a follow-up of 6~18 months. Conclusion Though it was not preoperative transcatheter arterial embolization, the endoscopic surgery using high frequency electrotome with suction device can be used to treated nasopharyngeal angiofibroma which either limited to nasopharyngeal cavities and paranasal sinus with intraoperative blood pressure control.
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Objective:To discuss the bacteria detection before and after disinfection by using central negative pressure suction device terminal socket, reduce cross infection probability in hospitals and provide evidence for disinfection management specification. Methods:one hundred and thirty clinical central terminal devices with negative pressure were disinfected spirally with iodine swabs and among them, Department of respiration 48, Department of cerebral surgery 46, and Pediatrics 36, were sampled and sent to be cultured by clinical laboratory personnel before and after disinfection. The specimens were administered in a sterile blood AGAR plate culture medium, and the bacterial growth conditions were observed to detect the bacteria number as pollution standards. Results: The pollution rates of clinical equipment central pressure suction into the terminal socket after disinfection were: Department of respiration 8.33%; Department of cerebral surgery 6.52%; Pediatrics 5.56%, and the average pollution rate was 7.69%.The detected cases of pathogenic bacteria were gram-negative bacteria pollution, and contrasting the pollution rates before and after disinfection was statistically significant(x2=14.08, P<0.05). Conclusion: Using based iodine swabs disinfection central pressure suction mouth terminal socket can reduce the cross infection between the patients with risk and provide patients with safe medical environment.