Primary and secondary postoperative hemorrhage in pediatric tonsillectomy  

作　　者：Bin Xu Hai-Yan Jin Ke Wu Cao Chen Li Li Yang Zhang Wei-Zhong Gu Chao Chen 

机构地区：[1]Department of Otorhinolaryngology-Head and Neck Surgery,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,Hangzhou 310052,Zhejiang Province,China [2]Department of Anesthesiology,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,Hangzhou 310052,Zhejiang Province,China [3]Department of Operating Room,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,Hangzhou 310052,Zhejiang Province,China [4]Department of Pathology,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,Hangzhou 310052,Zhejiang Province,China [5]Department of Radiology,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,National Children's Regional Medical Center,Hangzhou 310052,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2021年第7期1543-1553,共11页世界临床病例杂志

摘　　要：Tonsillectomy is the most common procedure for treatment of pediatric recurrent acute tonsillitis and tonsillar enlargement that contributes to obstructive sleep apnea hypopnea syndrome.Postoperative hemorrhage of tonsillectomy is a lifethreatening complication.AIM To identify the risk factors that may contribute to primary and secondary postoperative hemorrhage in pediatric tonsillectomy.METHODS The clinical data from 5015 children,3443 males and 1572 females,aged 1.92-17.08 years,with recurrent tonsillitis and/or tonsil hypertrophy who underwent tonsillectomy in our hospital from January 2009 to December 2018 were retrospectively collected.The variables including sex,age,time of onset,diagnosis,method of tonsillectomy,experience of surgeon,time when the surgery started and monthly average air temperature were abstracted.The patients with postoperative hemorrhage were classied into two groups,the primary bleeding group and the secondary bleeding group,and their characteristics were compared with those of the nonbleeding group separately.Statistical analysis was performed by chi-square test with SPSS 20.RESULTS Ninety-two patients had post-tonsillectomy hemorrhage,and the incidence rate of post-tonsillectomy hemorrhage was 1.83%.The mean age was 5.75 years.Cases of primary hemorrhage accounted for approximately 33.70%(31/92),and cases of secondary hemorrhage occurred in 66.30%(61/92).The rate of reoperation for bleeding was 0.92%,and the rate of rehospitalization for bleeding was 0.88%in all patients.Multiple hemostasis surgery was performed in 6.52%(3/46)of patients.The method of tonsillectomy(coblation tonsillectomy)and experience of the surgeon(junior surgeon with less than 5 years of experience)were significantly associated with primary hemorrhage(χ^(2)=5.830,P=0.016,χ^(2)=6.621,P=0.010,respectively).Age(over 6 years old)and time of onset(more than a 1-year history)were significantly associated with secondary hemorrhage(χ^(2)=15.242,P=0.000,χ^(2)=4.293,P=0.038,respectively).There was no signicant differen

关 键 词：Postoperative hemorrhage TONSILLITIS Sleep apnea OBSTRUCTIVE TONSILLECTOMY CHILD 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]