Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Laryngoscope. 2011 Nov;121(11):2322-6. doi: 10.1002/lary.22179. Epub 2011 Oct 12.
OBJECTIVES/HYPOTHESIS: To analyze the incidence of primary bleeding following tonsil surgery and to evaluate risk factors.
Register study of the results from the National Tonsil Surgery Register in Sweden covering the period 1997 to 2008 and 54,696 operations.
Data were collected by means of three questionnaires, two filled in by professionals and one 6 months postoperatively by the patient/parent.
A total of 719 patients experienced primary postoperative bleeding during the hospital stay (1.3%). A number of independent factors were correlated with decreased risk of post-tonsillectomy hemorrhage: younger age (P < .0001), female sex (P < .0001), type of surgery (tonsillotomy) (P = .0006), and surgery performed on a day-surgery basis (P < .0001). Indication for surgery and number of operations performed at the department did not correlate with postoperative bleeding risk. A significant decrease in primary postoperative hemorrhage rate from 2% to 0.96% was found during the study period.
Primary hemorrhage following tonsil surgery is rare. During the study period, a significant decrease in primary bleeding rates occurred. The changes in practice with an increasing proportion of day-surgery cases and tonsillotomy have contributed to the reduced risk, but cannot completely explain the reduction.
目的/假设：分析扁桃体手术后原发性出血的发生率，并评估风险因素。
对瑞典全国扁桃体手术登记处 1997 年至 2008 年期间的 54696 例手术结果进行登记研究。
通过三份问卷收集数据，两份由专业人员填写，一份由患者/家长在术后 6 个月填写。
共有 719 例患者在住院期间发生原发性术后出血（1.3%）。一些独立因素与扁桃体切除术后出血风险降低相关：年龄较小（P<0.0001）、女性（P<0.0001）、手术类型（扁桃体切开术）（P=0.0006）和日间手术（P<0.0001）。手术指征和科室手术次数与术后出血风险无关。研究期间，原发性术后出血率从 2%降至 0.96%，呈显著下降趋势。
扁桃体手术后原发性出血罕见。在研究期间，原发性出血率显著下降。日间手术病例和扁桃体切除术比例的增加导致风险降低，但不能完全解释这种减少。
