Coordes Annekatrin, Soudry Janina, Hofmann Veit Maria, Lenarz Minoo
Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4535-4541. doi: 10.1007/s00405-016-4146-7. Epub 2016 Jun 21.
There are gender-specific differences in the frequency and course of different diseases. Specifically, some studies have shown an increased risk of post-tonsillectomy hemorrhage (PTH). The aim of the study was to investigate gender-specific risk factors for hemorrhage after tonsillectomy (TE)/abscess-TE. We anonymously reviewed and recorded the relevant data of all patients (≥14 years) who underwent a TE/abscess-TE between 2011 and 2013 in the ENT Clinic of the Charité Universitätsmedizin Berlin, Campus Benjamin Franklin. A patient survey was used to complete missing data. We analyzed gender-specific risk factors for PTH. During the study period, 460 operations were performed and the data of 250 patients were analyzed (213 TE and 37 abscess-TE). The median patient age was 27 years (ranging from 14 to 83 years). The rate of primary PTH (<24 h after TE/abscess-TE) was 3 %, and the rate of secondary PTH (>24 h) was 23 %. A significantly higher PTH rate was associated with males (p = 0.037), which was still apparent in ages 21-30 after sub-classification. Multivariate analysis calculated diagnosis, regular alcohol consumption and administration of glucocorticoids to be independent risk factors associated with gender. In conclusion, the PTH rate is gender-specific, and male patients are at higher risk, especially in young adulthood. Therefore, doctors should advise male patients of the increased risk of bleeding and stress the importance of compliance. Also, close postoperative follow-up is desirable.
不同疾病的发病频率和病程存在性别差异。具体而言,一些研究表明扁桃体切除术后出血(PTH)的风险增加。本研究的目的是调查扁桃体切除术(TE)/扁桃体脓肿切除术(abscess - TE)后出血的性别特异性风险因素。我们对2011年至2013年在柏林夏里特大学医学中心本杰明·富兰克林校区耳鼻喉科诊所接受TE/abscess - TE手术的所有患者(≥14岁)的相关数据进行了匿名回顾和记录。通过患者调查来补充缺失数据。我们分析了PTH的性别特异性风险因素。在研究期间,共进行了460例手术,分析了250例患者的数据(213例TE和37例abscess - TE)。患者的中位年龄为27岁(范围为14至83岁)。原发性PTH(TE/abscess - TE后<24小时)的发生率为3%,继发性PTH(>24小时)的发生率为23%。男性的PTH发生率显著更高(p = 0.037),在按年龄分组后,21 - 30岁年龄段的男性中这一差异仍然明显。多变量分析计算得出诊断、经常饮酒和使用糖皮质激素是与性别相关的独立风险因素。总之,PTH发生率具有性别特异性,男性患者风险更高,尤其是在青年期。因此,医生应告知男性患者出血风险增加,并强调依从性的重要性。此外,术后密切随访是可取的。