儿童扁桃体切除术后出血率及出血程度分级的初步探讨

目的　统计儿童扁桃体切除术后出血率，根据Windfuhr分级法衡量儿童扁桃体术后出血的程度。方法 统计2010年3月～2013年3月在深圳市儿童医院行扁桃体切 除或扁桃体加腺样体切除患儿资料，统计术后出血发生率。结果　1672例患儿扁桃体切除术后出血16例，出血率为0.96%。女童术后出血率1.8%明显高于男童出血率0.53%，差异有统计学意义（χ 2=5.545，P <0.05）；原发性出血6例，继发性出血10例。出血程度1级9例，2级7例。结论 儿童扁桃体切除术后出血率很低，遇有活动性出血者应手气管插管全麻下止血。

Frequency and the severity of post-tonsillectomy hemorrhage in children

OBJECTIVE To evaluate the frequency of post-tonsillectomy hemorrhage, to classify the severity of post-tonsillectomy hemorrhage according to the fourgrade classification. METHODS Children who underwent tonsillectomy and/or adenoidectomy at Shenzhen Children Hospital between March 2010 and March 2013 were included in this study. The bleeding event of the every child was recorded. The severity of post-operative hemorrhage was classified in four grades. RESULTS Hemorrhage occurred in16（0.96%） of the patients after tonsillectomy. Statistical difference was found between boys（0.53%） and girls（1.8%, χ^2=5.545, P〈0.05） in postoperative bleeding rate. Primary post-tonsillectomy hemorrhage occurred in 6 patients（0.36%） and secondary hemorrhage in 10 patient（0.60%）. The grade 1 bleeding occurred in 9 patients and grade 2 in 7 patients. CONCLUSION The frequency of post-tonsillectomy hemorrhage was very low. For children with active bleeding, hemostasis should be performed under endotracheal anesthesia in operating room.