Macassey Emily A, Baguley Campbell, Dawes Patrick, Gray Andrew
Department of Otorhinolaryngology, Head and Neck Surgery, Dunedin Public Hospital, and Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
ANZ J Surg. 2007 Jul;77(7):579-82. doi: 10.1111/j.1445-2197.2007.04154.x.
Post-tonsillectomy haemorrhage is a significant complication because of its frequency and consequences. Increases in post-tonsillectomy haemorrhage prevalence have been reported. There is a controversy about whether increasing the use of diathermy techniques or anti-platelet aggregation effects of analgesia could have caused this increase. We carried out an audit of post-tonsillectomy haemorrhage and examined the rates of readmission for bleeding during the period 1990-2004. We also recorded the surgical technique used and the use of perioperative non-steroidal anti-inflammatory drugs and corticosteroids. During this period there has been a significant increase in post-tonsillectomy haemorrhage with an average annual increase of 15.3% (P<0.0001, 95% confidence interval 8.5-22.5%). The increase is coincidental with the change-over to predominant diathermy technique and a routine use of postoperative non-steroidal anti-inflammatory drugs and steroids.
扁桃体切除术后出血是一种严重的并发症，因其发生频率和后果所致。已有报道称扁桃体切除术后出血的发生率有所增加。对于增加使用透热技术或镇痛的抗血小板聚集作用是否会导致这种增加存在争议。我们对扁桃体切除术后出血进行了一次审计，并检查了1990年至2004年期间因出血再次入院的比率。我们还记录了所使用的手术技术以及围手术期非甾体抗炎药和皮质类固醇的使用情况。在此期间，扁桃体切除术后出血显著增加，平均每年增加15.3%（P<0.0001，95%置信区间8.5 - 22.5%）。这种增加与主要采用透热技术以及术后常规使用非甾体抗炎药和类固醇的转变同时发生。
