腮腺手术后继发性出血12例分析

12 cases analyses of postoperative secondary hemorrhage of parotid gland

目的 :探讨腮腺手术后继发性出血的原因和防治措施。方法 :1993 -2 0 0 2年间进行各类腮腺手术42 8例 ,对术后发生继发性出血的 12例临床资料进行分析总结。结果 :腮腺手术后继发性出血的发生率为 2 .75 % ,继发性出血多发生于术后 12h内 ( 91.67% ) ,其中创面渗血占 75 % ,小血管结扎线滑脱占 16.67% ,未查见明确出血点占 8.3 3 % ,临床表现为术区肿胀压痛、皮肤青紫瘀斑 ,敷料上有大量鲜血渗出。结论 :为防止术后继发性出血 ,术中止血应彻底 ,术后 12h内应密切观察切口肿胀及渗血情况 ,一旦有继发性出血发生应及时手术探查 ,重新止血。

Objective:To investigate the cause and preventive method of postoperative secondary hemorrhage. Method:428 cases various parotidectomy had been performed in 1993,1-2002,12 at our hospital;The records of 12 cases who had occurred postoperative secondary hemarrhage were retrospectively analysed. Result:The incidence of postoperative secondary bleeding of parotid gland was 2.75% The postoperative secondary bleeding had most occurred within 12 hours of postoperation.The rate of oozing with blood ,detachment of tied vessel ,no finding obvious bleeding spot was 75%,16.67%,8.33% respectively The clinical presentations were swelling and tenderness of operative region,blood stasis of facial and neck skin and having much bright-red blood on the bandage. Conclusion:To prevent postoperative secondary hemorrhage of parotid gland ,the most imoortant thing is to stop thouroghly bleeding during operation and observe carefully swelling and oozing with blood of wound within 12 hours of postoperation If having postoperative secondary hemorrhage,operation and hemostate again must be permored early.