Müzeyyen YILDIRIM, Edip GÜNYEL, İsmail TOPÇU

Tonsillektomide bizmut subgallatın hemostatik etkisi

Tonsillektomi operasyonlarında bizmut subgallatın kanamayı azaltmada ve operasyon süresini kısaltmada etkili olup olmadığını değerlendirmektir. Dicle Üniversitesi Tıp Fakültesi KBB kliniğinde 2002 - 2006 tarihleri arasında adenotonsillektomi yapılan 60 pediatrik hasta üzerinde prospektif çalışma yapıldı. Hastalar rastgele kontrol grubu ve bizmut subgallat uygulanan grup olarak iki gruba ayrıldı. Her iki grupta 30 hasta mevcuttu. Bütün hastalara adenotonsillektomi yapıldı. Tonsillektomi sırasında ve kanama kontrolu sırasında biriken kan miktarı ölçüldü. Tonsillektomi sonrasında hemostaz için bir gruba Manigla tarafından tarif edilmiş olan bizmut subgallat içeren tampon kullanıldı. Kontrol grubunda ise adrenalin emdirilmiş tampon kullanıldı. Tonsillektomi sonrasında oluşan kanama miktarı bizmut subgallat grubunda 60-110 ml (ortalama 82.66±10.96), kontrol grubunda ise 85-110ml (ortalama 94.27±11.31) olarak bulundu. Tonsillektomi süresi bizmut subgallat grubunda 12-35 dk. (ortalama 21.30±5.81 dk), kontrol grubunda ise 15-40 dk (ortalama 24.05±5.94 dk) bulundu. Kullanılan bağlama sayısı bizmut subgallat grubunda 0-3 adet (ortalama 1.26±1.08 adet), kontrol grubunda ise 0-4 adet (ortalama 2.11±1.19 adet) idi. Hemostaz sağlamak için kullanılan tampon sayısı ise bizmut subgallat grubunda 4-8 adet (ortalama 5.46±1.07 adet) iken kontrol grubunda 4-12 adet (ortalama 6.35±1.86 adet) bulundu. Bizmut subgallat kullanılan grupta tonsillektomi sonrasında kanama miktarında, operasyon süresinde, kullanılan bağlama sayısında ve kullanılan tampon sayısında istatistiksel olarak anlamlı azalma tespit ettik (p

Anahtar Kelimeler:

Kanama, Tonsillektomi, Hemostaz, Zaman

The hemostatic effect of bizmut subgallat in tonsillectomy

The aim our study is to evaluate the effect of bismuth subgallate on the tonsillektomy operations. The 60 pediatric patient were studied in the data between 2002 to 2006 in at University of Dicle, Faculty of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery Clinic. The patients were at random divided in to two group. The adenotonsillectomy were conducted for all patients. During the tonsillectomy the blood was collected and measured. In order to obtain the hemostasis, bismuth subgallate told used in the as described by Manigla. The swab with epinephrine was used in control group. The blood collected during tonsillectomy in control group was found to be between 85- 110 ml (avarage 94.27±11.31), and in bismuth subgallate group was found to be between 60 to 110ml (avarage 82.66±10.96). The time for tonsillectomy in control group was found tobe between 15 to 40 minute( avarage 24.05±5.94) and for bizmut subgallat to be between 12 to 35 minute (avarage 21.30±5.81). The number of surgical ties in order to obtain the hemostasis, for control group was found to be between 0-4 (avarage 2.11±1.19) and for bismuth subgallate group was found to be between 0-3 (avarage 1.26±1.08). Again, in order to optain hemostasis the used swap was number for control group was found to be between 4-12 (avarage 6.35±1.86) and for bismuth subgallate group was found to be between 4-8 (avarage 5.46±1.07). In the bizmut subgallat group, the bleeding amount, the operation time, the used number of surgical ties and the used swabs number were found tobe reduced respectively. These values were found meaningful statiscally (p<0.001). There was no meaningful differences between the two groups in the sence of postoperative morbidity.

Keywords:

Hemorrhage, Tonsillectomy, Hemostasis, Time,

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