低温等离子消融扁桃体切除术后出血的原因与对策

目的 探讨低温等离子消融扁桃体切除术后出血原因、预防及处理技巧.方法 回顾性分析2011年5月-2013年4月应用低温等离子消融扁桃体切除术患者临床资料.结果 301例患者中术后出血8例,发生率为2.66％,4例为原发性出血,4例为迟发性出血.原发性出血中3例为扁桃体下极出血需全麻缝合止血,1例为局部创面少量渗血.迟发性出血中1例为扁桃体下极出血经全麻下缝合止血,2例为扁桃体创面感染后出血,1例为饮食不当导致创面渗血,经抗感染治疗后痊愈.结论 术中止血不彻底、伤口局部炎症是低温等离子消融扁桃体切除术后出血的主要原因.扁桃体下极是最易出血部位,扁桃体下极缝合及抗感染治疗是可靠的止血方式.

Causes and countermeasures of postoperative hemorrhage following coblation-assisted tonsillectomy

Objective To explore the possible reason and treatment technique for postoperative hemorrhage follow ing coblation assisted tonsillectomy. Method The clinical data of 301 patients who underwent coblation assisted ton sillectomy between May 2011 and April 2013 were retrospectively analyzed. Results 8 cases （2.66%） suffered post tonsillectomy hemorrhage. Among them 4 cases experienced primary bleeding and 4 had secondary bleeding. 4 cases had bleeding at inferior pole of tonsil which needed hemostatic control under endotracheal anesthesia. 2 cases had bleeding with wound infection and needed anti infective therapy and 2 cases only experienced minor bleeding. Conslusion The incidence of postoperative hemorrhage following coblation assisted tonsillectomy is mainly related to stanch bleeding in sufficiently in surgery and infections. Suture and anti infective therapy are reliable methods of hemostasis.