低温等离子儿童扁桃体切除术后出血的原因及对策  

The Causes and Strategies of Child's Tonsil Postoperative Bleeding after Low Temperature Plasma Ablation

作　　者：李育广[1] 曾京宇[1] 刘茜[1] 

机构地区：[1]江西鹰潭解放军第184医院,江西鹰潭335000

出　　处：《赣南医学院学报》2016年第4期606-609,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的：探讨低温等离子儿童扁桃体切除术后出血的原因,根据出血情况采取相应的处理方法。方法：回顾性分析我科2011年1月~2015年3月应用低温等离子行扁桃体切除术或合并腺样体切除术404例儿童患者资料。结果：404例中,发生术后活动性出血6例,出血率1.49%。其中原发性出血2例,迟发性活动性出血4例。原发性出血原因多为术中未确切处理出血血管;迟发性出血原因多为术后感染。3例经保守治疗出血停止,3例重新全麻插管止血。术后需再次全麻插管止血率7.42‰。结论：儿童扁桃体低温等离子切除术后出血率很低,出血原因多为术中止血不彻底,术后感染。对术后出血儿童根据出血情况,采取保守治疗或全麻插管止血。Objective： To investigate the causes of child＇s tonsil postoperative bleeding after low temperature plasma ablation and propose the corresponding strategies. Methods： Retrospective analysis of information from 404 children patients with tonsil resection by low temperature plasma ablation or by ablation in combination with adenoidectomy in our department from January 2011 to March 2015. Results： Among 404 cases,there were 6 patients with active bleeding with postoperative hemorrhage rate was 1. 49%. Among 6 patients,there were 2 cases of primary hemorrhage and 4 cases of lateonset active hemorrhage. Primary hemorrhage was mainly caused by inappropriate treatment of bleeding vessels and lateonset hemorrhage was mainly caused by infection after surgery. Three cases of postoperative bleeding stop bleeding after conservative treatment and 3 cases stop bleeding after another general anesthesia intubation. The hemostatic rate that required postoperative general anesthesia intubation was 7. 42‰. Conclusion： The bleeding rates of children after tonsil resection by low temperature plasma ablation are very low. The bleeding is mainly caused by inappropriate treatment of bleeding vessels or infection after surgery. The conservative treatment or general anesthesia intubation are needed for children to stop the postoperative bleeding based on hemorrhage conditions.

关 键 词：儿童 等离子消融术 扁桃体切除术 出血 

分 类 号：R762[医药卫生—耳鼻咽喉科]