RESUMO
OBJECTIVE: To explore and analyze the clinical effect and potential value of a double-capsule fecal catheter device in patients with fecal incontinence in the intensive care unit (ICU). METHODS: A total of 107 patients with fecal incontinence who were admitted to the ICU of the First Affiliated Hospital of Gannan Medical University from May 2017 to April 2023 were selected and randomly divided into the observation group and the control group, with 68 cases in the observation group and 39 cases in the control group. The observation group was given a double-capsule fecal catheter device, and the control group was given an ordinary fecal catheter device for drainage. The clinical baseline data, adverse events, skin conditions, changes of patients' quality of life (QoL), indicators from laboratory test, working pressure and burden of nursing, average length of stay (ALOS) and prognosis of patients were compared between the two groups. RESULTS: There was no significant difference in age, gender, body mass index (BMI), hypertension history, diabetes mellitus history and smoking history between the observation group and the control group (all P>0.05). The occurrence probability of the number of catheter obstructions, perianal leakage, catheter prolapse and the incidence of discomfort reactions in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<0.01). After the use of the double-capsule fecal catheter device, the skin condition of the patient's perineum and perianal area was significantly improved and remained dry and comfortable for a long time, and the recovery of the primary disease in patients with fecal incontinence was also more optimistic. After application of the double-capsule fecal catheter device, the scores of QoL significantly increased in patients from the observation group (P<0.05). After using the double-capsule fecal catheter device, the levels of WBC, neutrophils count, PCT and IL-6 in the observation group were significantly lower than those in the control group after nursing (P<0.05). However, there was no significant difference in levels of CRP, TNF-α, albumin and prealbumin between the two groups (P>0.05). The responsible nurses of the patients in the control group expressed significantly higher nursing work burden than the observation group (P<0.05). Patients in the observation group had shorter ALOS and lower mortality than those in the control group (P<0.01). CONCLUSION: The application of the novel double-capsule fecal catheter device can reduce the adverse events and working pressure and burden of nursing, it also improved skin condition and patients' QoL. Correspondingly, it improved relevant prognostic indicators during the patient's hospitalization. It has beneficial clinical practicability and popularity for fecal incontinence in patients, and it is worthy of use and promotion.
RESUMO
Tonsillectomy is a common, minimally invasive, and relatively safe surgical operation. Although the surgical technology for such minor operations is mature and widely available in most countries worldwide, postoperative adverse complications occur and may be hazardous and fatal. Our article presents the details of a 4-year-old boy who suddenly developed pneumothorax and systemic extensive subcutaneous emphysema after tonsillectomy. He received professional treatment from a multi-disciplinary team (MDT) and timely rescue in our hospital; however, he died tragically. To this end, there is an urgent need to raise clinicians' awareness of the potentially fatal and rare complications that can occur after tonsillectomy.