同期行鼻腔手术对扁桃体切除和腭咽成形术后出血率的影响

Influence of single-staged nasal surgery on postoperative hemorrhage of tonsillectomy and Uvulopalatopharyngoplasty

目的评估同期行鼻腔手术对扁桃体切除和腭咽成形术后出血率的影响。方法回顾性调查分析2005年5月～2010年10月间,本院所有行扁桃体切除术和悬雍垂腭咽成形术并联合行鼻腔手术的患者的出血率。分析同期行鼻腔手术是否改变了扁桃体切除术和腭咽成型术患者术后的岀血率。结果本组病例共1 012例,其中204例同期行鼻腔手术。扁桃体切除术后出血共56例,发生率为5.5%。单纯行扁桃体切除术或行扁桃体切除术的悬雍垂腭咽成型术与同期行鼻腔手术的患者之间差异无统计学意义(分别为6.0%和3.9%;P=0.30)。结论扁桃体切除术和悬雍垂腭咽成型术同期行鼻腔手术没有增加术后出血比率,可不必分期手术,患者仅需一次麻醉和一次术后恢复过程,而无增加术后出血的危险。

Objiective To evaluate the effects of single-staged nasal surgery on the occurrence of postoperative hemor- rhage after tonsillectomy or uvulopalatopharyngoplasty. Methods Patients admitted in our hospital, from Mayl0, 2005, to October31, 2010, who had undergone single-staged tonsillectomy/uvulopalatopharyngoplasty with nasal sur- gery, were reviewed. Results In a total of 1 012 patients, the rate of postoperative hemorrhage was 5.5%. Among the patients, 204 underwent nasal surgery at the same time. No significant difference was found in the hemorrhage rate between the patients with nasal surgery or without nasal surgery （6.0% and 3.9%, respectively; P = 0.30）. Conclu- sion Single-staged nasal surgery does not appear to increase the rate of postoperative hemorrhage in patients undergoing tonsillectomy or UPPPT. This suggests that surgeons can perform single-staged procedures under one-time anesthesia without the risk of increased postoperative hemorrhage.