扁桃体术后严重出血21例临床分析

Clinical Analysis of Serious Hemorrage after Tosilectomy-Reaport of 21 Cases

目的 探讨扁桃体术后出血的原因和治疗方法。方法 对 2 1例扁桃体术后严重出血者进行回顾性分析。结果 在 2 6 5例扁桃体手术中 ,术后出血约在 10 0ml以上者 2 1例 ,占 7 9%。其中 18例为原发性出血。出血时间多发生于术后 2h内。出血以血管性出血为主。多可寻见明确出血点。止血方法微波局部烧灼止血 12例 ,局部压迫止血 1例 ,结扎止血 1例 ,缝合止血 5例 ,扁桃体窝内置纱球后缝合舌咽腭弓残缘 2例。结论 扁桃体术后出血为一常见的术后并发症 ,治疗上有一定难度 。

Objective Analasis bleeding reason after tonsilectomy, summarize experience of treatmeat. Methods The clinic date of 21 patients with hemorrage after tonsilectomy were analyzed and the relevant literratures were reviewed. Results Out of 365 patients with tonsilectomy, 21 patients had a serious complicatient of hemorrage (bleeding volume over 100 ml). Among then 18 cases were primary hemorrage and 3 secondary. The primary bleeding time was within 2 hours after operation. Most of hemorrage were from bleeding vessal. The bleeding vessal and point can be found in most of cases. Macrowave coagulation was used successfully in 12 cases, local physical pressure in 1, legation in 1, suture in 5.2 bleeding case was stopped by sutured the free edge of palatoglossal and palatopharygeal fold after putting a cotten ball with styptic. Conclusion For the hemorrage is the most commen and dangerous complication after tosilectomy the ENT docter shoud grasp and have a good knowledge of hemostasis method.