儿童扁桃体腺样体低温等离子射频消融术后出血特点分析及应对策略

Analysis and solution of postoperative haemorrhage in pediatric coblation adenotonsillectomy

目的探讨低温等离子射频消融和传统手术行儿童扁桃体腺样体切除术在术后出血方面存在的差异特点,并提出应对策略。方法选取2014年于我科行扁桃体腺样体射频消融术999例为等离子组,2010年于我科行扁桃体腺样体切除术1275例为传统组。比较两组总出血率、原发性及继发性出血的发生率、出血部位、出血程度和治疗方法的差异。结果等离子组术后总出血率、出血部位分布、出血程度和治疗方法分布上与传统组相比差异无统计学意义。等离子组术后原发性出血少于传统组,而继发性出血多于传统组,差异有统计学意义。结论等离子手术与传统手术相比并不增加术后出血几率,在出血部位分布、治疗方法分布上亦无明显差别;但术后原发性出血减少,而继发性出血升高,分析等离子手术后出血的常见原因,并针对性提出应对策略。

OBJECTIVE To investigate the disparation of hemor rhage bet ween the coblation and traditional adenotonsillectomy in children, and find the coping strategies. METHODS The children who had performed the coblation adenotonsillectomy in Tianjin childrens hospital between Jan. 1, 2014 and Dec. 31, 2014 were selected for the coblation group. The children who have perfor med traditional adenotonsillectomy in Tianjin childrens hospital between Jan. 1, 2010 and Dec. 31, 2010 were selected for the traditional group. The total rate of hemorrhage, the rate of primary hemorrhage, the rate of secondary hemorrhage, the site of bleeding, the degree of bleeding and the management methods of the two groups were compared. RESULTSThere were no statistically significant differences in the total rate of hemorrhage, the site and the degree of bleeding, and management methods between the two groups. The rate of primary bleeding in the coblation group was lower than that in traditional group, however the rate of secondary bleeding in the coblation group was higher than that in traditional group. CONCLUSION The coblation assisted adenotonsillectomy does not increase the postoperative bleeding rate in children.