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成人扁桃体切除术:适应证与并发症分析

Tonsillectomy in adults: Analysis of indications and complications.

作者信息

Galindo Torres Blanca Pilar, De Miguel García Félix, Whyte Orozco Jaime

机构信息

Department of Otorhinolaryngology, Miguel Servet University Hospital, Zaragoza, Spain.

Department of Otorhinolaryngology, Miguel Servet University Hospital, Zaragoza, Spain.

出版信息

Auris Nasus Larynx. 2018 Jun;45(3):517-521. doi: 10.1016/j.anl.2017.08.012. Epub 2017 Sep 18.

DOI:10.1016/j.anl.2017.08.012
PMID:28927847
Abstract

OBJECTIVE

Tonsillectomy is one of the surgical techniques most practiced by otolaryngologists, and despite being a relatively simple technique; it presents a considerable percentage of complications, such as postoperative bleeding. The aim of this study is to describe the surgical indications and most frequent complications, analyze whether surgical suture of the tonsillar pillars has an influence on bleeding, and study the data of hospital stay and its importance for the control of complications.

METHODS

A retrospective study of 326 patients who underwent a tonsillectomy in our Department of Otolaryngology from 2006 to 2014 was conducted. The obtained data were statistically analyzed using the Excel and SPSS 21.0 programs.

RESULTS

The most frequent indication was recurrent tonsillitis, with a 74.85% (244) occurrence, and the most recurrent complication was bleeding, in 5.21% (17) of the tonsillectomies, requiring surgical revision 13 of the 17 patients. No statistically significant differences in the risk of bleeding were observed in patients in whom tonsil pillars were sutured comparing to those that were not. No statistically significant differences were detected associating surgical indication and oropharyngeal post-tonsillectomy hemorrhage. All operated patients were admitted, with a postoperative average hospital stay of 2.17 days, gaining a quick and effective control of the immediate complications.

CONCLUSION

Bleeding is the most common and important complication. No statistically significant association between bleeding and tonsil pillar suture or surgical indication was found. Tonsillectomy was not set as outpatient surgery at the time.

摘要

目的

扁桃体切除术是耳鼻喉科医生最常施行的手术技术之一,尽管该技术相对简单,但仍存在相当比例的并发症,如术后出血。本研究的目的是描述手术适应证和最常见的并发症,分析扁桃体柱的手术缝合是否对出血有影响,并研究住院时间数据及其对并发症控制的重要性。

方法

对2006年至2014年在我院耳鼻喉科接受扁桃体切除术的326例患者进行回顾性研究。使用Excel和SPSS 21.0程序对获得的数据进行统计分析。

结果

最常见的适应证是复发性扁桃体炎,发生率为74.85%(244例),最常见的并发症是出血,在扁桃体切除术中占5.21%(17例),17例患者中有13例需要手术修正。与未缝合扁桃体柱的患者相比,缝合扁桃体柱的患者在出血风险上未观察到统计学显著差异。在手术适应证与扁桃体切除术后口咽出血之间未检测到统计学显著差异。所有手术患者均入院,术后平均住院时间为2.17天,对近期并发症获得了快速有效的控制。

结论

出血是最常见且重要的并发症。未发现出血与扁桃体柱缝合或手术适应证之间存在统计学显著关联。当时扁桃体切除术未设为门诊手术。

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