Analysis Of Hemorrhage In Coblation Of Adenoid In Adenoidal Hypertrophy In Children

Objective:Observe the bleeding volume and spots during adenoidectomy for two group of children with traditional curettage and coblation, analyze the relative factors about hemorrhage and the advantage in reduction bleeding volume with coblationMethod:100 cases of children with adenoid hypertrophy were recruited from June 2007 to June 2009. traditional curettage was carried out for 35 cases of them(group 1)and coblation was carried out for the others(group 2). We calculated the bleeding volumes and spots for two different surgical procedures, respectively. Meanwhile, after making variable convert for age, pathogenesis and adenoid size with SPSS statistical package for Windows, we calculated the partial correlation coefficient about bleeding volume and forementioned indexes to investigate the factors affecting bleeding volume.Result1.Bleeding volumes of two kinds of surgical proceduresThe bleeding volume on average of two groups was 32±5.86ml and 4.23±2.5 ml,respectively.Significant statistical sense was confirmed after making paired t test.2.Results of hemorrhage spots during surgeryExtensive errhysis came up after the excise the adenoid in every case of group 1by traditional curettage.bleeding volume of 8 cases were about 30ml,repetat compress the bleeding volume of 8 cases were about 30ml, repetat compress the bleeding area for a long time to stop bleeding.2 of them bleed severe at posterior extremity of nasal septum during the surgery (35.4ml and 42.3ml),unable to stop bleeding completely by compression and then using bipolar electric coagulation to stop bleeding.Less blood loss happened in group 2 by coblation, about 5 ml.bleeding volumes of 35 cases were less than 1 ml. Diffuse errhysis came up during surgery in 45 cases of children,about 3ml.the bleeding spots of 30cases were concentrated at the juncture of adenoid and nasal septum,which was thought to be the feeding artery of adenoid.We stop bleeding smoothly by using coblation3.Statistical analysis of factors related to bleeding volumesAfter making variable convert for age,pathogeneses and adenoid size,multiple linear regression was performed by using SPSS statistical package for Windows.Partial correlation coefficients on bleeding volumes were 0.40,0.59,0.25,respectively,.which made significant statistical signify-cance and suggested that bleeding volumes by coblation were related to age,pathogenesis and adenoid sizes of children.Conclusion1.Coblation is able to significantly reduce bleeding volume during adenoidectomy and stop bleeding satisfactorily.It is no doubt that coblation is a safe, minimally invasived and stopbleeding satisfactorily.It is no doubt that coblation is a safe,minimally invasived and effective therapeutic method2.According to the result of statistically analysis on factors related tobleeding volumes,bigger age, longer pathogenesis and larger size of adenoids mean more bleeding volume during surgery.3.Coblation surgical procedure mainly ablation the adenoid tissue from middle line to bilateral gradually.Specified adenoid tissue that may canse obstructive or oppressive symptom should be ablated completely.4.Hemorrhage often happened at posterior extremith of nasal septum in clinical adenoidectomy.Further relative fundamental research should be dong in future to figure out whether the feeding artery of adenoid via this area.