52例扁桃体术后出血诊治疗效观察  

Observation of 52 Cases Using Different Methods to Stop Bleeding of Postoperative Pemorrhage Following Tonsillectomy

作　　者：宋朝 马华安[1] 吴继勇[1] Song Chao;Ma Huaan;Wu Jiyong(Department of Oto Laryngology,Jiangsu Province Hospital of TCM,Nanjing,210000,China)

机构地区：[1]江苏省中医院,江苏南京210000

出　　处：《中国医学文摘（耳鼻咽喉科学）》2020年第1期1-3,9,F0002,共5页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的探讨扁桃体切除术后出血的多种止血措施疗效,为临床实践提供指导。方法回顾性分析52例等离子扁桃体切除术后出血患者的临床资料,采用双氧水棉球局部压迫、利多卡因稀释液局部肌注间接压迫、双极电凝固、缝合结扎四种处理方式,观察24小时内止血治疗效果。结果本研究中52例患者共计发生出血70次;止血操作成功事件中,双氧水棉球压迫占28例(28/36,77.78%)、利多卡因液肌注压迫5例(5/7,71.43%)、双极电凝固19例(19/19,100%)、缝合结扎8例(8/8,100%),与双氧水棉球压迫、利多卡因液肌注压迫相比,双极电凝固与缝合结扎两种方式的止血成功率显著更高(χ^2=7.355,P=0.037)。结论扁桃体切除术后出血是一常见并发症,采用双极电凝固法或缝合结扎法可以有效的彻底止血。Objective To investigate the effect of various hemostasis measures for postoperative hemorrhage following tonsillectomy,thus provide the guidance for the clinical treatment.Methods A retrospective analysis of 52 patients underwent postoperative hemorrhage following tonsillectomy was performed.Four hemostasis measures were used,including local compression with hydrogen peroxide cotton ball,indirect compression of local intramuscular injection of lidocaine diluent,bipolar coagulation hemostasis and suture ligation,the effect of hemostasis within 24 hours was observed and recorded.Results In this study,52 patients had 70 times of bleeding.28 cases of local compression with hydrogen peroxide cotton ball,5 cases of indirect compression of local intramuscular injection of lidocaine diluent,19 cases of bipolar coagulation hemostasis and 8 cases of suture ligation had combined together make a series of successful hemostasis events.With Fisher definite probability methods,compared to the previous two measures,bipolar coagulation hemostasis and suture ligation have a significantly higher success rate to stop bleeding(χ^2=7.355,P=0.037).Conclusions Hemorrhage after tonsillectomy is a common complication,bipolar coagulation hemostasis and suture ligation both are effective hemostasis method.

关 键 词：扁桃体切除术 手术后出血 止血效果 

分 类 号：R47[医药卫生—护理学]