儿童扁桃体及腺样体低温等离子切除术后出血的观察

A CLINICAL STUDY OF HEMORRHAGE AFTER COBLATION TONSILLECTOMY AND ADENOIDECTOMY IN CHILDREN

目的探讨应用低温等离子手术方式行儿童扁桃体及腺样体切除术后出血的原因。方法回顾性分析全麻下低温等离子技术行扁桃体及腺样体切除病儿1 120例(其中扁桃体并腺样体切除840例,单纯腺样体切除280例)的临床资料,分析术后原发性及继发性出血的发生率、出血部位、出血程度和出血原因。结果术后出血41例,发生率为3.7%,其中原发性出血9例,继发性出血32例。腺样体术后出血4例,均为原发性出血;扁桃体术后出血37例,其中原发性出血5例,继发性出血32例。术后出血的41例病儿中,术后伴有哭闹者6例,进食不当者15例,感染及频繁咳嗽者7例,无明显诱因者9例。结论儿童扁桃体及腺样体低温等离子切除术后出血可能与手术医师手术技术、术后饮食不当、术后护理、术后感染及频繁咳嗽等因素相关。

Objective To investigate the causes of hemorrhage after coblation tonsillectomy and adenoidectomy in children. Methods A retrospective analysis was performed for the clinical data of 1 120 children who underwent coblation tonsillectomy with or without adenoidectomy under general anesthesia,and among these children,840 underwent tonsillectomy combined with adenoidectomy and 280 underwent adenoidectomy alone.The incidence rates of primary and secondary hemorrhage after surgery,bleeding site,degree of bleeding,and cause of bleeding were analyzed. Results Of all children,41（3.7%）experienced postoperative hemorrhage,among whom 9 had primary hemorrhage and 32 had secondary hemorrhage.Four children experienced primary hemorrhage after adenoidectomy;37 children experienced hemorrhage after tonsillectomy,among whom 5 had primary hemorrhage and 32 had secondary hemorrhage.Among the 41 children who experienced postoperative hemorrhage,6 had cry and scream,15 had improper eating habits,7 had postoperative infection and frequent cough,and 9 had no apparent trigger. Conclusion Hemorrhage after coblation tonsillectomy and adenoidectomy in children is associated with surgical technique,improper eating habits,postoperative nursing,postoperative infection,and frequent cough.