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儿童与成人扁桃体切除术后延迟出血的差异。

Difference of delayed post-tonsillectomy bleeding between children and adults.

作者信息

Kim Dong Wook, Koo Ja-Won, Ahn Soon-Hyun, Lee Chul Hee, Kim Jeong-Whun

机构信息

Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Goomi-dong, Bundang-gu, Seongnam 463-707, Republic of Korea.

出版信息

Auris Nasus Larynx. 2010 Aug;37(4):456-60. doi: 10.1016/j.anl.2009.11.011. Epub 2010 Jan 19.

Abstract

OBJECTIVE

To analyze the characteristics of post-tonsillectomy bleeding and its management comparing with adults.

METHODS

A retrospective chart review of 1489 patients who underwent tonsillectomy in our institution (June 2003-June 2006).

RESULTS

Post-tonsillectomy bleeding rate was 3.1%, 2.5% and 10.8% in younger children (age< or =11 years), older children (12< or =age< or =15 years) and adults (age>15 years), respectively. Although adults showed an unimodal peak time for onset of post-tonsillectomy bleeding, children showed a bimodal peak time. In the younger child group, all of the 28 bleeders had spontaneous hemostasis. However, in the older child group, there was no spontaneous hemostasis. Bleeding was controlled under local anesthesia in 3 patients and 2 patients required general anesthesia for bleeding control. In the adult group, spontaneous cessation of bleeding occurred in 25 patients (60.9%) and hemostasis under local or general anesthesia was performed in 16 (39.1%) patients.

CONCLUSIONS

Post-tonsillectomy bleeding occurred more frequently in adults than in children. Spontaneous hemostasis was more prevalent in children than in adults. Post-tonsillectomy bleeding in the younger child group was controlled with close observation alone.

摘要

目的

分析扁桃体切除术后出血的特点及其处理方法,并与成人进行比较。

方法

对我院2003年6月至2006年6月期间接受扁桃体切除术的1489例患者进行回顾性病历分析。

结果

年龄≤11岁的年幼儿童、12≤年龄≤15岁的年长儿童和年龄>15岁的成人扁桃体切除术后出血率分别为3.1%、2.5%和10.8%。虽然成人扁桃体切除术后出血的发病时间呈单峰,而儿童呈双峰。在年幼儿童组中,28例出血者均自行止血。然而,在年长儿童组中,没有自行止血的情况。3例患者在局部麻醉下控制了出血,2例患者需要全身麻醉来控制出血。在成人组中,25例患者(60.9%)出血自行停止,16例患者(39.1%)在局部或全身麻醉下止血。

结论

扁桃体切除术后出血在成人中比在儿童中更常见。儿童比成人更易出现自行止血。年幼儿童组的扁桃体切除术后出血仅通过密切观察即可控制。

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