Department of Otolaryngology, ShenZhen People's Hospital, Shenzhen, Guangdong, China.
Department of Otolaryngology, 8th Medical Center, PLA General Hospital, Beijing, China.
Am J Otolaryngol. 2021 Jan-Feb;42(1):102760. doi: 10.1016/j.amjoto.2020.102760. Epub 2020 Oct 18.
Coblation tonsillectomy (TE) increases gradually in China. Hemorrhage is the main complication after tonsillectomy. The conclusions of the studies about suture after tonsillectomy are conflicting. To compare the post-tonsillectomy hemorrhage (PTH) rates in patients who underwent coblation with vs. without suture.
This was a randomized controlled study of adult patients who underwent coblation TE at our hospital between 01/2017 and 08/2019. The patients were randomized to TE with or without suture. The primary endpoint was the secondary PTH. The secondary endpoints included the primary PTH, grade of PTH, and incidence of PTH within 4 weeks post-TE.
There were no differences between the two groups regarding sex, age, disease course, and BMI (all P > 0.05). The occurrence of secondary PTH was lower in the suture group compared with the non-suture group (2.8% vs. 7.7%, P = 0.016). Compared with non-suture group, the incidence of PTH within 4 weeks (2.8% vs. 10.6%, P = 0.009) and the PTH degree (P = 0.02) were all significantly lower in the suture group.
Intraoperative suture reduces the secondary PTH in adult patients who underwent coblation tonsillectomy. The incidence of PTH within 4 weeks, PTH degree and pain might all improved for intraoperative suture.
在中国,等离子扁桃体切除术(TE)的应用逐渐增多。出血是扁桃体切除术后的主要并发症。关于扁桃体切除术后缝合的研究结论存在争议。本研究旨在比较行等离子扁桃体切除术患者中缝合与不缝合术后出血(PTH)的发生率。
这是一项在我院于 2017 年 1 月至 2019 年 8 月期间行等离子扁桃体切除术的成年患者的随机对照研究。患者随机分为行缝合的 TE 组和不行缝合的 TE 组。主要终点为次要 PTH。次要终点包括原发性 PTH、PTH 程度和 TE 后 4 周内 PTH 的发生率。
两组患者的性别、年龄、病程和 BMI 无差异(均 P>0.05)。缝合组的继发性 PTH 发生率低于非缝合组(2.8%比 7.7%,P=0.016)。与非缝合组相比,缝合组 TE 后 4 周内 PTH 的发生率(2.8%比 10.6%,P=0.009)和 PTH 程度(P=0.02)均显著降低。
对于行等离子扁桃体切除术的成年患者,术中缝合可降低继发性 PTH。术中缝合可降低 4 周内 PTH 的发生率、PTH 程度和疼痛。