摘要
目的:分析儿童扁桃体切除术后继发性出血的危险因素,为减少扁桃体手术后的并发症提供理论依据。方法:回顾性分析354例行扁桃体切除术患儿的临床资料,其中继发性出血42例(出血组),312例为非出血组,对2组性别、年龄、手术原因、扁桃体包埋程度、手术方式、手术者熟练程度、术中出血量、术后有无上呼吸道感染进行统计学分析,分析儿童扁桃体切除术后继发性出血的危险因素,并探讨其中的发病机制。结果:2组性别、手术原因、手术者熟练程度、术中出血量和术后有无上呼吸道感染之间差异无统计学意义,年龄、扁桃体包埋程度、手术方式在2组之间差异有统计学意义。进一步对后3项相关因素行多因素Logistic回归分析,扁桃体包埋程度和手术方式与出血之间存在明显相关。结论:扁桃体切除术后出血是一种常见并且有潜在致死性并发症,扁桃体包埋程度和手术方式是其危险因素。
Objective:To analyze the risk factors of secondary post-tonsillectomy hemorrhage(PTH)in children,and to provide a theoretical basis for reducing complications after tonsillectomy.Method:A retrospective analysis of 354 children underwent tonsillectomy was performed,among which 42 secondary hemorrhage cases were divided into bleeding group,and other 312 cases were divided into non-bleeding group.To analyze the risk factors of secondary PTH and to discusses the pathogenesis of the hemorrhage,statistical analysis was conducted among eight clinical data including gender,age,reason of surgery,degree of tonsil embedding,surgery approach,surgeon’s skill level,intra-operative hemorrhagic volume,and postoperative absence of upper respiratory tract infection.Result:Univariant analysis showed that there was no statistical difference of gender,reason for operation,surgeon’s skill level,intra-operative hemorrhagic volume and postoperative upper respiratory tract infection different between bleeding group and non-bleeding group,while there was significant statistical difference of age,degree of tonsillar embedding,and surgery approach.Further multivariate logistic regression analysis of the three relevant factors showed that there was a significant correlation between the degree of tonsillar embedding and the surgery approach and the hemorrhage.Conclusion:Hemorrhage after tonsillectomy is a common and potentially fatal complication,with risk factors of the degree of tonsillar embedding,and the surgery approach.
作者
田莉
林镝
TIAN Li;LIN Di(Department of Otolaryngology,Children's Hospital of Nanjing Medical University,Nanjing,210008,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2018年第23期1813-1816,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
