Analysis of the causes of immediate bleeding after pediatric adenoidectomy
10.3760/cma.j.issn.1673-0860.2011.06.011
- VernacularTitle:儿童腺样体切除术后出血原因分析
- Author:
Hong-Guang PAN
1
;
Lan LI
;
Yong-Tian LU
;
De-Lun ZHANG
;
Xiang-Yu MA
;
Zhi-Xiong XIAN
Author Information
1. 广东省深圳市儿童医院
- Keywords:
Adenoidectomy;
Postoperative hemorrhage;
Child
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2011;46(6):491-494
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the incidence of postoperative hemorrahage in children undergoing adenoidectomy , and to discuss its possible causes. Methods Included in this study were children who underwent adenoid and/or tonsil surgery at Shenzhen Chilidren's Hospital between January 2004 and November 2009. The change of hemoglobin ( Hb) and hematocrit ( Hct) were retrospectively analysed. The blood loss was estimated by the change of Hct. Results There were 2078 cases that accomplished the inclusion criteria in the period of study. Ten children bled 0. 5 - 4. 0 hours after surgery,without superfluous hemorrahage during the operation and post-tonsillectomy. This represented an incidence of 0.48% of immediate postoperative haemorrhage among the 2078 procedures analyzed. Statistical differences were found between boys (0.21%) and girls (1.10%, x2 =5.597, P<0.05). The change of Hb and Hct was positively correlated (r = 0. 95 , P < 0. 01) , the blood loss was positively correlated with the bleeding time ( r = 0. 66, P < 0. 05 ) . The causes of postoperative hemorrhage were coagulation system deficits, chronic nasopharyngitis, deficient hemostasis and immoderate ravage. To control the postoperative hemorrhage, 2 postnasal packing under topical anaesthesia and 8 electrocautery under general anaesthesia were applied. Conclusions Poor operative technique and deficient hemostasis are the major causes of primary hemorrahage. Prompt operation to control the postoperative bleeding should be done 2 hours after bleeding under general anesthesia in order to avoid severe complications.
