儿童扁桃体术后不同处理方式对预防出血作用的探讨

Study on post-tonsillectomy haemorrhage about two kinds of shelling methods of tonsillectomy

目的探讨防止儿童扁桃体切除术后出血的有效方法。方法将491例儿童扁桃体切除术患儿随机分为两组:治疗组(术创缝合组)199例,对照组(术创未缝合组)267例。两组病例均行常规儿童扁桃体切除术,治疗组术后把腭舌弓、腭咽弓及扁桃体窝组织一并缝合,修复创面,封闭创腔;对照组经压迫止血及扁桃体窝内止血缝扎达到止血效果,术创未予缝合。对比研究术创缝合与未缝合术后出血并发症的发生情况。结果治疗组无1例发生术后出血;对照组发生原发性出血8例,继发性出血2例,出血的发生率2.90%。术后观察患儿哭闹情况及进食情况,治疗组与对照组比较,差异无统计学意义(P>0.05)。结论全麻下行儿童扁桃体术后将腭舌弓、腭咽弓及扁桃体窝组织一并缝合,封闭创腔,可防止术后出血,有利创口愈合,预防感染,符合外科原则。

Objective To study two kinds of methods of tonsillectomy （shelling method, separating shelling method）, compare two kinds methods of tonsillectomy in Post-tonsillectomy haemorrhage. Methods 491 patients were operated tonsillectomy,all tonsils were divided into 2 groups：the tonsillectomy with suture palatopharyngeal arch and palatoglossal arch group and the traditional without suture palatopharyngeal arch and palatoglossal arch group, compare two kindsmethods of tonsillectomy in Post-tonsillectomy haemorrhage. Results Post tonsillectomy haemorrhage of the tonsillectomy with suture palatopharyngeal arch and palatoglossal arch group was statistically less than the traditional without suture palatopharyngeal arch and palatoglossal arch group Conclusion Suture palatopharyngeal arch and palatoglossal arch offers a better effect than no suture about obviating post-tonsillectomy haemorrhage.