Chowdhury K, Tewfik T L, Schloss M D
Department of Otolaryngology, Montreal Children's Hospital, Quebec, Canada.
J Otolaryngol. 1988 Feb;17(1):46-9.
This is a retrospective review of 6842 tonsillectomies and adenoidectomies performed over a seven-year period at the Montreal Children's Hospital. The total incidence of postoperative bleeding was 2.5%. The incidence of primary post-tonsillectomy hemorrhage was 1.0%, with 78% of these children having developed bleeding within 12 hours of surgery. The overall incidence of secondary post-tonsillectomy hemorrhage was 1.2%. Twenty-nine percent of children with primary hemorrhage required a second general anesthetic, and 40% required blood component transfusion. Eight percent of children with secondary hemorrhage required a second general anesthetic and 24% received transfusions. Based on these findings, primary and secondary hemorrhage can be classified further into major and minor. The criteria for a major post-tonsillectomy hemorrhage are: requirements of a general anesthetic to control and repair the bleeding, or blood loss that is sufficient to require blood component transfusion therapy. The relevance of these findings with regard to outpatient adenotonsillectomies is discussed.
这是一项对蒙特利尔儿童医院在七年时间里进行的6842例扁桃体切除术和腺样体切除术的回顾性研究。术后出血的总发生率为2.5%。扁桃体切除术后原发性出血的发生率为1.0%，其中78%的患儿在手术后12小时内出现出血。扁桃体切除术后继发性出血的总体发生率为1.2%。原发性出血的患儿中有29%需要再次全身麻醉，40%需要输血。继发性出血的患儿中有8%需要再次全身麻醉，24%接受了输血。基于这些发现，原发性和继发性出血可进一步分为严重出血和轻微出血。扁桃体切除术后严重出血的标准是：需要全身麻醉来控制和修复出血，或失血量足以需要输血治疗。本文还讨论了这些发现对于门诊腺样体扁桃体切除术的意义。
