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扁桃体切除手术中及术后最危险并发症是术区出血,可以引起病人死亡.本文将我科近8年扁桃体手术后出血情况进行了统计分析.1 临床资料手术病人2264例,成人896例,儿童(14岁以下)1368例,术后出血人数28例,占1.2%.出血时间:术后3小时以内22例,4小时3例,5小时2例,32小时1例.出血部位;扁桃体窝后外侧壁出血21例,其中16例在扁桃体上静脉出血,5例在扁桃体窝前侧壁,2例前弓出血.由此看来扁桃体上静脉出血率高,与手术中经常损伤有关.出血时间3小时内占全出血人数78.6%,4小时内占89.3%,5小时内占96.4%;出血病人中剥离手术占20例.挤切手术占8例,成人19例,儿童9例;出血量由数十毫升至数百毫升不等,多在200～350ml左右,最多1例出血估计在1200ml,无1例死亡,均在手术止血后出血停止,多数采用的是局部结扎止血,少数棉球压迫止血.少数门诊手术病人回家后出血,回院止血治疗.
Tonsillectomy surgery and the most dangerous postoperative complications is bleeding in the operation area, can cause the patient’s death.This article will make a statistical analysis of bleeding after tonsillectomy in our department in recent 8 years.1 Clinical data 2264 cases of surgery, 896 adults, The number of children (below 14 years old) was 1368, and the number of postoperative bleeding was 28 (1.2%). Bleeding time: 22 cases within 3 hours after operation, 3 cases after 4 hours, 2 cases after 5 hours and 1 case after 32 hours. Twenty-one cases of hemorrhage occurred in the lateral wall of the popliteus, including 16 cases of hemorrhage in the tonsil vein, 5 cases of anterior tonsil fossa, and 2 cases of anterior bow hemorrhage, suggesting that tonsil venous hemorrhage was associated with frequent injuries during surgery. Bleeding time within 3 hours accounted for 78.6% of the total number of bleeding, 89.3% within 4 hours, 96.4% within 5 hours; bleeding surgery in 20 cases of exfoliated surgery accounted for 8 cases, 19 adults and 9 children; Bleeding volume from tens of milliliters to hundreds of milliliters, mostly in about 200 ~ 350ml, a maximum of 1 bleeding was estimated at 1200ml, no one death, bleeding stopped after surgery to stop bleeding, the majority of local ligation to stop bleeding, a small number Cotton ball compression hemostasis. A small number of outpatient surgery patients go home bleeding, back to stop bleeding treatment.