儿童鼾症腺样体扁桃体切除术患儿术后出血情况及其危险因素调查

目的:探讨儿童鼾症(OSAS)腺样体扁桃体切除术患儿术后出血情况及其危险因素调查。方法:纳入我院2018年3月—2019年5月进行儿童鼾症(OSAS)全身麻醉下行腺样体扁桃体切除术的200例患儿为研究对象,观察术后恢复情况,术后出血31例设为观察组,术后无出血的169例设为对照组。查阅一般临床资料,采用单因素临床数据分析以及多因素Logistic回归法分析患儿术后出血危险因素。结果:200例OSAS患儿术后发生出血31例,出血率15.5%。经多因素Logistic回归分析显示,患儿年龄(OR=1.796)、术中副损伤(OR=4.251)、家属照护情况(OR=3.198)、饮食配合度(OR=2.674)、睡眠呼吸暂停严重程度(OR=3.667)以及抗生素使用(OR=0.893)是影响切除术患儿术后出血的独立因素(P<0.05)。结论:OSAS腺样体扁桃体切除术患儿术后出血危险因素诸多且复杂,严重威胁患儿生命健康,医护人员应协助家属提升操作者熟练程度、患儿服药饮食等依从性,以达到降低术后出血风险。

Investigation on postoperative bleeding and risk factors of adenoid tonsillectomy in children with ob-structive sleep apnea syndrome

Objective:To investigate the postoperative bleeding and its risk factors of adenoid tonsillectomy in children with obstructive sleep apnea syndrome(OSAS).Methods:A total of 200 children with OSAS who underwent adenoid tonsillectomy with general anesthesia in our hospital from March 2018 to May 2019 were included in this study.The postoperative recovery was observed,in which 31 cases with postoperative bleeding were set as the observation group and 169 cases without postoperative bleeding were set as the control group.The risk factors of postoperative bleeding in children with OSAS were analyzed by consulting the general clinical data,using the single-factor clinical data analysis and multivariate Logistic regression.Results:In 200 children with OSAS,31 had postoperative bleeding,with a bleeding rate of 15.5%.Multivariate logistic regression analysis showed that the child′s age(OR=1.796),intraoperative collateral injuries(OR=4.251),family care status(OR=3.198),dietary coordination(OR=2.674),the severity of sleep apnea(OR=3.667),and the use of antibiotics(OR=0.893)were independent factors affecting postoperative bleeding in children underwent adenoid tonsillectomy(P<0.05).Conclusions:There were many and complex risk factors for postoperative bleeding in children with OSAS who underwent adenoid tonsillectomy,which seriously threatens the life and health of the children.Medical staff should assist the family members to improve the proficiency of the operator and the compliance of the children with medication and diet to reduce the risk of postoperative bleeding.