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15218例扁桃体切除术和腺样体切除术后出血情况

Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients.

作者信息

Windfuhr J P, Chen Y S, Remmert S

机构信息

Department of Otorhinolaryngology, Plastic Head and Neck Surgery, St. Anna Hospital, Duisburg, Germany.

出版信息

Otolaryngol Head Neck Surg. 2005 Feb;132(2):281-6. doi: 10.1016/j.otohns.2004.09.007.

Abstract

OBJECTIVE

To evaluate potential risk factors and the incidence of bleeding following adenoidectomy or tonsillectomy, with or without adenoidectomy requiring surgical treatment under general anesthesia.

STUDY DESIGN AND SETTING

Retrospective chart review of 15,218 patients who underwent surgery between January 1, 1988, and September 30, 2001, at our institution (St. Anna Hospital, Duisburg).

RESULTS

A total of 229 patients experienced postoperative bleeding (1.5%). Patients of male gender and 70 years of age or older were significantly at risk for post-tonsillectomy hemorrhage. The incidence of bleeding increased with age. Of the bleeding episodes, 76% occurred on the day of surgery; immediate abscess-tonsillectomy was not associated with an increased risk of bleeding.

CONCLUSIONS

Hemorrhage following tonsillectomy and adenoidectomy is rare and predominantly occurs early after surgery. Male patients, 70 years of age or older, infectious mononucleosis, and a history of recurrent tonsillitis were identified as risk factors for post-tonsillectomy hemorrhage. Delayed hemorrhage has the potential to be life-threatening.

摘要

目的

评估腺样体切除术或扁桃体切除术(无论是否同时行腺样体切除术)在全身麻醉下进行手术治疗后的潜在风险因素及出血发生率。

研究设计与背景

对1988年1月1日至2001年9月30日期间在我们机构(杜伊斯堡圣安娜医院)接受手术的15218例患者进行回顾性病历审查。

结果

共有229例患者发生术后出血(1.5%)。男性患者以及70岁及以上患者扁桃体切除术后出血风险显著增加。出血发生率随年龄增长而升高。在出血事件中,76%发生在手术当天;即刻脓肿扁桃体切除术与出血风险增加无关。

结论

扁桃体切除术和腺样体切除术后出血罕见,且主要发生在术后早期。男性患者、70岁及以上、传染性单核细胞增多症以及复发性扁桃体炎病史被确定为扁桃体切除术后出血的风险因素。延迟性出血有可能危及生命。

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