扁桃体术后出血26例临床分析

Clinical analysis of 26 cases of hemorrhage after tonsillectomy

目的探讨扁桃体切除术后出血的发生因素及其预防和治疗。方法对本科2005-2012年间扁桃体切除术后并发出血的病例资料进行回顾性分析。结果1013例中，出血26例，出血率2．56％。成人组出血率高于儿童组，其差异具有极显著意义（P〈O．01）。原发性出血22例，继发性出血4例；男17例（17／607），女9例（9／406）；局麻剥离法2l例（21／470），局麻挤切法5例（5／543）；小量出血17例，中量出血6例，大量出血3例。出血患者均治愈。结论扁桃体术后出血与患者自身因素、技术操作因素及术后护理等因素有关，强调在于预防。一旦发生，宜视出血的部位、范围、性质及出血量的大小和局部有无感染等因素而采取不同的止血方法，在止血的同时，需注意纠正水和电解质平衡及止血、抗炎治疗。

Objective To explore the factors, prevention and treatment of bleeding after tonsillectomy. Method The clinical data were retrospectively analyzed in cases with bleeding after tonsillectomy during 2005 and 2012. Result 23 cases of hemorrhage were found in all of 1013 cases with a bleeding rate of 2.56%. The bleeding rate was higher in the adults group than in the children group significantly （P〈0.01） .There were 22 cases of primary bleeding and 4 cases of secondary hemorrhage. 17 cases in men group（17/607）, and 9 cases in Women group（9/406）. 21 cases were treated by dissection under local anesthesia （21/470）, and 5 cases were treated by guillotine under local anesthesia （5/543）. 17 cases were reported with small amount of hemorrhage, 6 cases with middle bleeding, and 3 cases with heavy bleeding. It showed that all of the cases were cured. Conclusion Patients with bleeding after tonsillectomy are related to the personal factors, technical factors and factors such as nursing after operation, prevention is stressed here. If it occurs once, different Hemostatic methods should be used according to the location, scope, nature and amount of bleeding and taken local factors such as infection, Meanwhile, we should pay attention to the balance of water and electrolyte, treatment of hemostatic and anti-inflammatory.