悬雍垂腭咽成形术后继发性出血的原因及处理

Causes and treatment of secondary hemorrhage after Uvulopalatopharyngoplasty

目的探讨悬雍垂腭咽成形术(UPPP)术后继发性出血的原因及处理方法,提出预防措施。方法采用"Windfuhr J"出血分度法将UPPP术后继发性出血分为5度,对476例行UPPP手术的病例进行回顾性分析。结果 UPPP术后出血26例,继发性出血(术后24 h之后的出血)17例(3.5%);1度出血5例(1.00%);2度出血7例(1.47%);3度出血2例(0.42%);4度出血3例(0.63%),无5度出血。原因有术中缝合不紧、术后血压控制不佳、咽部活动过度、咳嗽、创面感染、缝扎线脱落等。所有出血病例给予相应处理后血止。结论按照UPPP术后不同出血程度,探讨各程度出血的原因,便于及时做出准确判断,并采取有效可靠的处理措施,对临床预防UPPP术后继发性出血有指导意义。

Objective To discuss the causes and preventive methods of secondary hemorrhage after Uvulopalatopharyn- goplasty（UPPP）. Methods 476 UPPP procedures , performed from August 2002 to December 2010, were reviewed according to the Windfuhr J bleeding classification system. Results 26 patients suffered from postoperative bleeding, including 17 cases of secondary bleeding. We found that grade 1 bleeding occurred in 5 cases（ 1% ）, grade 2 in 7 cases （ 1.47% ）, grade 3 in 2 cases（0.42% ）, grade 4 in 3 cases（0.63% ） and there was no grade 5 bleeding. The causes of secondary hemorrhage included failed suture in the operation, poorly controlled blood pressure, postoperative cough, and wound infection. All patients were cured with proper treatment. Conclusion According to our findings, it is im- portant to decide surgical hemostatic intervention in time. Preventing secondary postoperative hemorrhage can be a- chieved by proper measures.