CC BY
6
yflK:616
Abdullaeva R.R.
Applicant,
Republican Multidisciplinary Children's Center of the Republic of Karakalpakstan,
Nukus, Uzbekistan Ashurov A.M.
Doctor of Medical Sciences, Center for the Development of Professional Qualification of Medical Workers,
Tashkent, Uzbekistan
EFFECTIVE METHODS OF TREATMENT OF HYPERPLASIA OF THE PHARYNGEAL TONSIL IN CHILDREN WITH IDA
Abstract
The article presents the results of clinical research on the proposed method of surgical treatment of adenoid vegetation, which expands the indications for surgical treatment of this pathology and increases the effectiveness of treatment, reducing complications, rehabilitation duration, and hospital stay.
Keywords
pharyngeal tonsil, hyperplasia, IDA, children. Relevance
Surgical treatment of children with pathology of the pharyngeal tonsil in the presence of accompanying diseases is currently a pressing issue [4].
In children with iron-deficiency anemia (IDA), hypertrophy of the pharyngeal tonsils can be particularly problematic, as IDA can lead to decreased immunity and increased risk of infections. Therefore, treatment of hypertrophy of the pharyngeal tonsils in these children may be required more frequently than in children without IDA [1,5].
In practical otorhinolaryngology, there is currently no consensus on what approach to take regarding adenoids in IDA. The absence of unified standards for diagnosis and treatment means that the choice of treatment method currently depends on which specialist the patient is being treated by [2].
There is an obvious need to develop a unified algorithm for the diagnosis and treatment of children with pharyngeal tonsil pathology and IDA. Given the wide prevalence of both lymphoepithelial ring diseases and IDA in the Republic of Karakalpakstan, this algorithm should be suitable for use in regional medical institutions [3].
Research goal: Objective: To develop an optimal method for surgical treatment of hypertrophy of the pharyngeal tonsil in children with IDA.
Materials and methods. Children with hypertrophy of the pharyngeal tonsils and iron-deficiency anemia (IDA) of 2-3 degrees were divided according to the severity of IDA. The patients were divided into three groups based on IDA classification: the control group consisted of children without IDA, the second group had mild IDA with hemoglobin levels between 90-120 g/L, and the third group had moderate IDA with hemoglobin levels between 70-89 g/L. Severe IDA, with hemoglobin levels below 70 g/L, was a contraindication for surgical treatment of hypertrophy of the pharyngeal tonsils.
Depending on the surgical method, all children were also divided into three groups. The first group included children who underwent surgery using the endoscopic microdebrider technique, the second group underwent adenoid tissue removal using an adenotome, and the third group underwent adenoidectomy using a Photec-type coagulator-adenotome. In all cases, the operation was performed under general endotracheal anesthesia, and hemostasis was achieved using a coagulator after the removal of the adenoid tissue.
Results. Our study aimed to identify the safest surgical method for adenoid tissue removal with minimal or no bleeding. To determine the amount of blood loss during each type of surgery, the collected volume of blood was measured using suction. The use of the microdebrider technique resulted in relatively more bleeding, possibly due to the longer duration of the operation compared to other adenoidectomy methods. In this case, the adenoid tissue is pulverized and mixed with blood, so the contents were passed through a sieve before measuring the volume of blood loss.
A correlation was found between blood loss and the degree of anemia. In each group, the volume of blood loss was determined during hypertrophy of the pharyngeal tonsils removal using the Beckman adenotome. The data showed that regardless of the severity of IDA, the volume of blood loss in all groups was similar. This suggests that with hemoglobin levels up to 80 g/L, the coagulation system is not a contraindication. However, the analysis of blood coagulation parameters also showed little difference between the groups.
Conclusion. For the treatment of children with hypertrophy of the pharyngeal tonsils of 2-3 degrees and mild IDA (hemoglobin levels between 90-120 g/L) or moderate IDA (hemoglobin levels between 70-89 g/L), adenotonsillectomy using the Beckman adenotome and a Photec-type coagulator-adenotome is recommended. However, for children with moderate IDA (hemoglobin levels between 70-89 g/L) and adenoid vegetations, adenoidectomy using the microdebrider technique is not recommended because the operation is relatively longer compared to other surgical methods and the volume of blood loss is higher. References:
1. Kozlov V.S., Shilenkova V.V., Karpov V.A. Adenoids: Conservative and Surgical Treatment. Moscow: Polygraphist and Publisher, 2009. 192 p. (in Russian)
2. Pukhlik S.M., Neyvert E.G. Adenoids, Adenoiditis, and AR // Clinical Immunology. Allergology. Infectology. 2008. - No. 5/2. - P. 16-20. (in Russian)
3. Terskova N.V. Chronic Adenoiditis. / N.V. Terskova // Siberian Medical Review - 2015. - No.4. - P. 85-92. (in Russian)
4. David H. et al. Indications for Tonsillectomy and Adenoidectomy. // The Laryngoscope. 2002. - No. 112. - P. 610.
5. Lavin J.M., Shah R.K. Postoperative complications in obese children undergoing adenotonsillectomy // Int J. Pediatr Otorhinolaryngol. 2015 0ct;79(10):1732-5.
© Abdullaeva R.R., Ashurov A.M., 2023
УДК 61
Атаева Г. С., преподаватель Джапаров М. П., преподаватель Гылыджова М. Дж., преподаватель Туркменский государственный медицинский университет имени Мырата Гаррыева
Ашхабад, Туркменистан
РОЛЬ И МЕСТО ПАРАМЕДИЦИНСКОЙ ПОМОЩИ В ОРГАНИЗАЦИИ ЗДРАВООХРАНЕНИЯ
Аннотация
Современный врач должен быть высокообразованным, открытым, искренним, гуманным, гуманным и всегда готовым прийти на помощь страждущим. Можно выделить такие виды медицинской помощи, как первая помощь, первая помощь на приеме у врача, первая помощь, расширенная
