中国中西医结合耳鼻咽喉科杂志
中國中西醫結閤耳鼻嚥喉科雜誌
중국중서의결합이비인후과잡지
Chinese Journal of Otorhinolaryngology In Integrative Medicine
2015年
4期
270-273
,共4页
张良%王亚娜%翟钊%周慧芳
張良%王亞娜%翟釗%週慧芳
장량%왕아나%적쇠%주혜방
扁桃体切除术%出血%风险因素%回归分析%并发症
扁桃體切除術%齣血%風險因素%迴歸分析%併髮癥
편도체절제술%출혈%풍험인소%회귀분석%병발증
post-tonsillectomy%hemorrhage%risk factors%complication%regression analys
目的 探讨扁桃体切除术后再出血的发生率, 并评价与术后再出血相关的风险因素. 方法 分析我院2003年至2013年692名住院行扁桃体切除术的患者. 其中发生术后出血者根据出血严重程度分三类:I:无创止血治疗后即可控制的极少量出血;II:需要局麻下止血的再出血;Ⅲ:需要全麻下止血的再出血. 采用logistic回归模型评价的风险因素指标包括:性别、年龄(成人和儿童)、扁桃体切除术术式、手术时间、结扎类型、术后抗生素使用时间等. 结果 692例患者中有80例发生术后出血,其中原发性和继发性出血分别占1.6%和10%.18例患者发生第三类再出血,再次手术的整体风险为2.6%,并且多于手术后5至6天高发,而且男性成年患者中发生率更高. 多因素logistic回归分析显示,成年患者和男性患者都是再出血发生的独立风险因素,也是第三类再出血发生的独立风险因素. 结论 男性患者和成年患者是再出血发生的独立风险因素,也是第三类再出血发生的独立风险因素.
目的 探討扁桃體切除術後再齣血的髮生率, 併評價與術後再齣血相關的風險因素. 方法 分析我院2003年至2013年692名住院行扁桃體切除術的患者. 其中髮生術後齣血者根據齣血嚴重程度分三類:I:無創止血治療後即可控製的極少量齣血;II:需要跼痳下止血的再齣血;Ⅲ:需要全痳下止血的再齣血. 採用logistic迴歸模型評價的風險因素指標包括:性彆、年齡(成人和兒童)、扁桃體切除術術式、手術時間、結扎類型、術後抗生素使用時間等. 結果 692例患者中有80例髮生術後齣血,其中原髮性和繼髮性齣血分彆佔1.6%和10%.18例患者髮生第三類再齣血,再次手術的整體風險為2.6%,併且多于手術後5至6天高髮,而且男性成年患者中髮生率更高. 多因素logistic迴歸分析顯示,成年患者和男性患者都是再齣血髮生的獨立風險因素,也是第三類再齣血髮生的獨立風險因素. 結論 男性患者和成年患者是再齣血髮生的獨立風險因素,也是第三類再齣血髮生的獨立風險因素.
목적 탐토편도체절제술후재출혈적발생솔, 병평개여술후재출혈상관적풍험인소. 방법 분석아원2003년지2013년692명주원행편도체절제술적환자. 기중발생술후출혈자근거출혈엄중정도분삼류:I:무창지혈치료후즉가공제적겁소량출혈;II:수요국마하지혈적재출혈;Ⅲ:수요전마하지혈적재출혈. 채용logistic회귀모형평개적풍험인소지표포괄:성별、년령(성인화인동)、편도체절제술술식、수술시간、결찰류형、술후항생소사용시간등. 결과 692례환자중유80례발생술후출혈,기중원발성화계발성출혈분별점1.6%화10%.18례환자발생제삼류재출혈,재차수술적정체풍험위2.6%,병차다우수술후5지6천고발,이차남성성년환자중발생솔경고. 다인소logistic회귀분석현시,성년환자화남성환자도시재출혈발생적독립풍험인소,야시제삼류재출혈발생적독립풍험인소. 결론 남성환자화성년환자시재출혈발생적독립풍험인소,야시제삼류재출혈발생적독립풍험인소.
Objective To investigate the rate of post-tonsillectomy hemorrhage (PTH) in a single institution and to evaluate the clinical risk factors for PTH. Methods We reviewed the records of 692 patients who underwent tonsillectomy (TE) in our hospital between 2003 and 2013. PTH grades were grouped into three categories according to the severity of the hemorrhagic episode:(Ⅰ) minimal hemorrhage that stopped after noninvasive treatment, (Ⅱ) hemorrhage requiring treatment with local anesthesia, and (Ⅲ) hemorrhage requiring reoperation under general anesthesia in the operating room. Clinical risk factors such as sex, age (adults vs. children), TE indication, operative time, ligature type, and duration of antibiotic administration for PTH were investigated. Results Among the 692 patients, 80 (11.6%) showed PTH, with primary and secondary hemorrhage accounting for 1.6% and 10.0%, respectively. A categoryⅢPTH was observed in 18 patients;thus, the overall risk of re-operation was 2.6%. The PTH episode most frequently occurred on postoperative days 5 and 6. The frequency of PTH was significantly higher in male patients and in adult. A stepwise multivariate logistic regression revealed that adult age and male gender were the independent risk factors for PTH. It also revealed that male gender and adult age were the independent risk factors for the category Ⅲ PTH. Conclusion Independent risk factors for PTH are adult age and male gender. The above two risk factorsarealso significant for category ⅢPTH.
