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扁桃体切除术后出血的发生率及处理:新加坡的经验

The incidence and management of post-tonsillectomy haemorrhage: a Singaporean experience.

作者信息

Ranjit S, Brett R H, Lu P K, Aw C Y

机构信息

Division of Otolaryngology, Changi General Hospital, Singapore.

出版信息

Singapore Med J. 1999 Oct;40(10):622-6.

Abstract

AIM OF STUDY

To audit the incidence and management of post-tonsillectomy haemorrhage in the Singaporean context.

METHODS

Three hundred and sixty-six consecutive tonsillectomies done over a 2-year period were retrospectively studied. Demographic details and indication for operation were evaluated in conjunction with the incidence and management of post-operative haemorrhage.

RESULTS

84.4% of the patients were adults while 58.7% were males. Chronic tonsillitis was the most common indication for operation (84.5%). The incidence of primary and secondary haemorrhage was 0.6% and 7.1% respectively. 3.8% of the patients had to return to the operation theatre to secure haemostasis. The use of post-operative antibiotics did not significantly affect the incidence of haemorrhage. There was no mortality from this complication. The haemorrhage rate was significantly higher among the adults (p = 0.048) and males (p = 0.019) in this study.

CONCLUSION

Our overall post-tonsillectomy haemorrhage rate was higher than that reported in most of the Western publications because adults rather than children predominated in our series. We report a low incidence of primary haemorrhage which is in keeping with the results of studies on electrodissection tonsillectomies. Our findings indicate that tonsillectomy is a safe procedure which can be performed on a day surgery basis if the patients are carefully selected.

摘要

研究目的

在新加坡背景下审核扁桃体切除术后出血的发生率及处理情况。

方法

对在两年期间连续进行的366例扁桃体切除术进行回顾性研究。结合术后出血的发生率及处理情况,评估患者的人口统计学细节及手术指征。

结果

84.4%的患者为成年人,58.7%为男性。慢性扁桃体炎是最常见的手术指征(84.5%)。原发性出血和继发性出血的发生率分别为0.6%和7.1%。3.8%的患者不得不返回手术室进行止血。术后使用抗生素对出血发生率没有显著影响。该并发症无死亡病例。在本研究中,成年人(p = 0.048)和男性(p = 0.019)的出血率显著更高。

结论

我们的扁桃体切除术后总体出血率高于大多数西方出版物报道的水平,因为我们的病例系列中成年人而非儿童占主导。我们报告的原发性出血发生率较低,这与电切扁桃体切除术的研究结果一致。我们的研究结果表明,如果仔细选择患者,扁桃体切除术是一种可在日间手术基础上进行的安全手术。

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