扁桃体术后出血的原因分析

Analysis of causes of post-tonsillectomy hemorrhage

目的:探讨扁桃体术后出血的常见原因,并提出相应的预防措施。方法:选取扁桃体切除术患者1 192例,根据其是否发生术后出血分为两组,对两组患者的基本资料和治疗情况进行统计学分析。结果:扁桃体术后出血者中成年、男性患者,合并高血压、肝脏疾病,术前长期服用阿司匹林,术前长期使用肾上腺皮质激素,局部麻醉,术中采取纱球压迫止血,术后剧烈咳嗽,不合理进食,以及围手术期存在焦虑情绪的患者所占比例明显高于未发生出血者,两组比较差异有统计学意义(P<0.05)。而患者是否合并糖尿病对其术后出血影响不大(P>0.05)。经Logistic回归分析,焦虑,合并高血压、肝脏疾病,使用纱球压迫止血,术后剧烈咳嗽以及不合理饮食都是患者发生扁桃体出血的原因(P<0.05)。结论:扁桃体术后出血与多方面的因素密切相关,在临床工作中应给予针对性的预防。

Objective：To investigate common causes of post-tonsillectomy hemorrhage and to raise appropriate preventative measures accordingly. Method：1192 cases with tonsillectomy were enrolled in and were divided into bleeding group and no bleeding group. And the general information and treatment were statistically analysed in both groups. Result： The proportion of patients with the following factors in bleeding group were significantly higher than that in no bleeding group（P〈0.05）. The adverse factors for bleeding consisted of adult male, hypertension, hepatic disease, preoperative long-term taking of aspirin and/or corticosteroids, local anesthesia, intraoperative pressing hemostasis by yarn ball, postoperative coughing, poor diet,as well as the presence of perioperative anxiety. And whether patients with diabetes or not had little effect on postoperative hemorrhage（P〉0.05） Logistic regression analysis indicated that causes of post-tonsillectomy hemorrhage include anxiety, hypertension, hepatic disease, intraoperative pressing hemostasis by yarn ball, postoperative intense coughing and poor diet （P〈 0.05）. Conclusion：The intimate causes of post-tonsillectomy hemorrhage are multifold and targeted preventative measures should be applied in the clinic.