Wall Jessica J, Tay Khoon-Yen
Department of Emergency Medicine, Penn Presbyterian Medical Center, 51 North 39th Street, Philadelphia, PA 19104, USA.
Division of Emergency Medicine, Children's Hospital of Philadelphia, 3501 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Emerg Med Clin North Am. 2018 May;36(2):415-426. doi: 10.1016/j.emc.2017.12.009. Epub 2018 Feb 10.
Post-tonsillectomy hemorrhage represents a potentially life-threatening condition that occurs in up to 5% of pediatric patients. Minor bleeding often precedes severe hemorrhage. Patients with minor or self-resolving bleeding should be observed in the emergency department or admitted for monitoring. Patients with severe bleeding should be immediately assessed for airway and hemodynamic stability. Management of severe bleeding includes immediate surgical consultation or initiation of the transfer process to a center with surgical capabilities, direct pressure to the site of hemorrhage with or without the additional of a hemostatic agent, possible rapid sequence intubation, and management of hemodynamic instability with volume resuscitation.
扁桃体切除术后出血是一种潜在的危及生命的情况，在高达5%的儿科患者中会发生。严重出血之前通常会有轻微出血。轻微出血或自行止血的患者应在急诊科观察或住院监测。严重出血的患者应立即评估气道和血流动力学稳定性。严重出血的处理措施包括立即进行外科会诊或启动转至有手术能力的中心的转诊流程、对出血部位直接加压（可加用或不加用止血剂）、可能需要快速顺序诱导插管，以及通过液体复苏处理血流动力学不稳定情况。
