低温等离子刀扁桃体腺样体切除术后出血原因及预防的探讨  

Causes and prevention of postoperative bleeding when using the low-temperature plasma coaplation in tonsillectomy and adenoidectomy

作　　者：张步勇[1] 李阳阳[1] 徐艳萍[1] 孟粹达[2] 黄芳林[1] 汤翠华[1] 文连姬[1] 刘岩[1] 蔡郁[1] 

机构地区：[1]吉林大学第二医院耳鼻咽喉头颈外科,吉林长春130041 [2]吉林大学中日联谊医院耳鼻咽喉头颈外科,吉林长春130033

出　　处：《中国耳鼻咽喉头颈外科》2013年第9期491-493,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨应用低温等离子刀行儿童扁桃体及腺样体切除术后出血的原因及预防。方法回顾分析2010年11月～2013年2月188例患儿应用低温等离子刀行扁桃体及腺样体切除术,年龄19个月～12岁,平均(5.3±3.1)岁,其中单纯行扁桃体切除60例,同时行扁桃体及腺样体切除69例,单纯行腺样体切除59例。结果 4例发生术后出血,其中3例为术后7～10 d,1例为术后24 h内,均为扁桃体切除术后出血,无腺样体切除术后出血病例。结论患儿自身因素及术者的操作水平是导致术后出血的重要原因,术前及术后宣教及护理、术中充分止血及较高的手术技巧是减少术后出血的关键。OBJECTIVE To explore the causes and prevention of children＇s postoperative bleeding after tonsillectomies and adenoidectomies with low-temperature plasma scalpel.METHODS Form November 2010 to February 2013,a retrospective analysis of 188 cases done tonsillectomies or/and adenoidectomies with low-temperature plasma scalpel.The age was between 19 months to 12 years old,and the average age was 5.3±3.1 years old.Among the 188 cases,60 cases were tonsillectomy-only,69 case were tonsillectomy-and-adenoidectomy while 59 cases were adenoidectomy-only.RESULTS There were 4 postoperative bleeding cases,all of cases were after tonsillectomies,3 cases started bleeding from 7 to 10 days after the surgery and 1 case within 24 hours after the surgery.The adenoidectomy postoperative bleeding did not occur.CONCLUSION The condition of the children and the skill level of surgeon are the important reasons to cause postoperative bleeding.The keys to reduce postoperative bleeding are as follow： to consult the patients for preoperative and postoperative,adequate hemostasis during the surgery and good surgical techniques.

关 键 词：手术后出血 扁桃体切除术 腺样体切除术 儿童 射频消融术 

分 类 号：R766[医药卫生—耳鼻咽喉科]