低温等离子切除扁桃体术后出血原因分析

Analysis on the causes of hemorrhage after low-temperature plasma tonsillectomies

目的分析低温等离子切除扁桃体术后出血的原因,为预防术后出血提供临床依据。方法回顾性分析2014年1月~2015年6月在我院行低温等离子扁桃体切除手术的227例患者的病历。收集患者一般临床资料,分析术后出血情况（出血部位、出血类型）及术后出血处理等临床资料。结果 227例行低温等离子扁桃体切除术,术后出血11例,其中原发性出血4例,迟发性出血7例;11例术后出血病例中有2例位于扁桃体窝上极,1例位于扁桃体窝内的弥漫性出血,8例位于扁桃体下极,本组低温等离子扁桃体术后出血发生率为4.8%。结论在扁桃体术后出血部位中扁桃体下极出血比例较高。术中止血不彻底、术后感染、术后饮食不当均为低温等离子扁桃体术后出血的影响因素,可分别对症预防。

Objective To analyze the causes of hemorrhage after low-temperature plasma tonsillectomies so as to provide clinical evidences for the prevention of postoperative hemorrhage.Methods A retrospective analysis was performed on 227 patients who underwent low-temperature plasma tonsillectomies in the hospital from January 2014 to June2015.The clinical data of patients containing general clinical data and postoperative hemorrhage（including the hemorrhage site and type） were collected and recorded.Results Among 227 patients who were involved in this study and underwent low-temperature plasma tonsillectomies,postoperative hemorrhage occurred in 11 cases（accounting for 4.8%）,including primary hemorrhage in 4 cases and delayed hemorrhage in 7 cases.Of the 11 cases of postoperative hemorrhage,2 cases were located in the upper pole of amygdaloid fossa;1 case of diffuse hemorrhage was located inside the amygdaloid fossa;8 cases were located in the inferior pole of amygdaloid fossa.Conclusion Postoperative hemorrhage in the upper pole of amygdaloid fossa accounts for a larger proportion.The causes of hemorrhage after low-temperature plasma tonsillectomies include unthorough intraoperative hemostasis,postoperative infections,improper postoperative diets,which can be prevented symptomatically.