Blomgren K, Qvarnberg Y H, Valtonen H J
Department of Otorhinolaryngology, Central Hospital of Central Finland, Jyvaskyla, Finland.
Laryngoscope. 2001 Mar;111(3):478-82. doi: 10.1097/00005537-200103000-00018.
Hemorrhages are main complications after tonsillectomy, whatever technique is used. This prospective study aimed at revealing pros and cons associated with monopolar electrodissection tonsillectomy.
A prospective study.
A prospective study on all patients undergoing tonsillectomy or adenotonsillectomy in Central Hospital of Central Finland in 1997. Operation time and bleeding, as well as perioperative and postoperative complications, were recorded.
Inpatient tonsillectomy was performed in 440 patients (mean age, 17.9 y). Primary post-tonsillectomy hemorrhage (within 24 h) occurred in 2.3%. A total of 15.9% of patients searched for medical help because of secondary post-tonsillectomy hemorrhage, 7.7% receiving active treatment and 8.2% not. Post-tonsillectomy hemorrhages proved to be most common in older patients and when peritonsillar abscess was in patient history.
Monopolar electrodissection tonsillectomy was fast and resulted in little intraoperative bleeding. However, postoperative hemorrhages were common, and the mean use of analgesics was for more than 10 days. Preoperative counseling must be thorough and realistic. Our results indicate that better methods for tonsillectomy still need to be developed.
无论采用何种技术，出血都是扁桃体切除术后的主要并发症。本前瞻性研究旨在揭示单极电切扁桃体切除术的优缺点。
一项前瞻性研究。
对1997年在芬兰中部中心医院接受扁桃体切除术或腺样体扁桃体切除术的所有患者进行前瞻性研究。记录手术时间、出血量以及围手术期和术后并发症。
440例患者接受了住院扁桃体切除术（平均年龄17.9岁）。扁桃体切除术后原发性出血（24小时内）发生率为2.3%。共有15.9%的患者因扁桃体切除术后继发性出血寻求医疗帮助，其中7.7%接受了积极治疗，8.2%未接受治疗。扁桃体切除术后出血在老年患者以及有扁桃体周围脓肿病史的患者中最为常见。
单极电切扁桃体切除术速度快，术中出血少。然而，术后出血很常见，平均镇痛药物使用时间超过10天。术前咨询必须全面且实际。我们的结果表明，仍需开发更好的扁桃体切除方法。
