Тонзилектомія в дітей: терапевтичні можливості в оптимізації результатів хірургічного втручання

Abstract

Tonsillectomy is one of the most common surgical interventions. The search for effective medical measures to optimize the course of regeneration processes in a postoperative wound is urgent. Purpose - to evaluate the effect of the complex homeopathic preparation Tonsilotren on the reparative processes of the postoperative period in children who underwent tonsillectomy. Materials and methods. The test group of 70 patients with chronic tonsillitis and 30 patients of the control group aged from 6 to 17 years were under observed and compared. All patients in the test group received Tonsilotren 7 days before surgery and for 2 weeks after surgical tonsillectomy. The examination of the ENT doctor was carried out during 5 visits: 1 visit before the operation, 2-5 visits - corresponded to the period from 1 to 14 days of the postoperative period. The results of observation were evaluated according to the following indicators: hyperemia of the mucous membrane of the faucial pillars, swelling of the mucous membrane of the faucial pillars, fibrinous pellicle in the postoperative wound, epithelization of the postoperative wound, bleeding from the postoperative wound, blood clots in the postoperative wound, scarring of the faucial pillars, pain intensity to VAS scale during swallowing and eating solid food, side effects, tolerability of the Tonsilotren medicine, complications of the disease, the need and duration of use of analgesics. Results. Prescribing of the Tonsilotren medicine to patients with chronic tonsillitis during and after surgical treatment (tonsillectomy) significantly increases the effectiveness of the treatment, namely: it helps to reduce the intensity of pain during swallowing and eating solid food, hyperemia and swelling of the mucous membrane of the faucial pillars, acceleration of epithelization of the postoperative wound, reduces scaring of faucial pillars (p<0.05). Epithelization of the postoperative wound with an area of more than 75% of its surface was observed in 24 (34.3%) patients on the 10th day and in 68 (97.1%) patients on the 14th day after the operation in the test group, while this indicator occurred in the control group only in 13 (43.3%) children on the 14th day after surgery. During observation, no side effects of the Tonsilotren medicine and adverse events were detected, which confirms the safety of its use. Conclusions. Course use of the Tonsilotren medicine in children in preparation for tonsillectomy and in the postoperative period demonstrates better effectiveness compared to standard treatment in terms of indicators of postoperative wound healing, rates of epithelization, absence of scarring and blood clots, and less pronounced pain syndrome. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.