低温等离子射频消融手术治疗儿童OSAHS术后出血原因分析及处理

王钧; 陈洁; 杨军

doi:10.13201/j.issn.1001-1781.2013.18.015

低温等离子射频消融手术治疗儿童OSAHS术后出血原因分析及处理

- 1 海门市人民医院耳鼻咽喉科(江苏海门, 226100);
- 2 上海交通大学医学院附属儿童医学中心耳鼻咽喉科;
- 3 上海交通大学医学院附属新华医院耳鼻咽喉-头颈外科上海交通大学医学院耳科学研究所

详细信息

通讯作者: 杨军,E-mail:otology-xinhua@hotmail.com

中图分类号: R563.8

收稿日期: 2012-12-25

Analysis and management of postoperative hemorrhage in surgery of obstructive sleep apnea hypopnea syndrome in children using plasma-mediated radio-frequency ablation at low temperature

- 1 Department of Otolaryngology, Haimen People's Hospital, Haimen, 226100, China;
- 2 Department of Otolaryngology, Children's Medical Center, Shanghai Jiaotong University School of Medicine;
- 3 Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Ear Institute, Shanghai Jiaotong University School of Medicine

More Information

Corresponding author: YANG Jun, E-mail: otology-xinhua@hotmail.com

Received Date: 25 December 2012

摘要

摘要: 目的:回顾性分析低温等离子射频消融手术治疗儿童OSAHS术后出血的原因、预防和治疗的方法。方法:4 028例OSAHS患儿在全身麻醉下使用美国Arthocare公司的ENT Colator Ⅱ等离子系统治疗仪,进行扁桃体和腺样体的消融手术。结果:4 028例患儿中发生术后出血者共37例,其中仅1例为腺样体术后出血,其余36例均为扁桃体术后出血。手术后原发性出血7例,其余30例均为继发性出血。经用不同方法止血后出血停止。结论:低温等离子射频消融手术创伤比较小,术中出血少,但少数患儿(0.92%)术后仍会有出血。术后出血的原因与术前未彻底控制炎症、医生的经验、术中止血不彻底、患儿术后哭闹烦躁、术后2周进食不当、凝血因子缺乏等有关。采用压迫止血,低温等离子射频,双极电凝处理术后出血,效果良好。
- 低温等离子射频消融手术 /
- 睡眠呼吸暂停低通气综合征,阻塞性 /
- 术后出血
Abstract: Objective: To analyze retrospectively cause, prevention and management of postoperative hemorrhage in surgery of obstructive sleep apnea hypopnea syndrome( OSAHS) in children using plasma-mediated radio-frequency(pmRF) ablation at low temperature.Method: Tonsil and adenoid ablation were carried out in 4 028 cases diagnosed with OSAHS, using ENTColator Ⅱ plasma system of Arthocare company under general anesthesia.Result: Postoperative hemorrhage occurred in 37 cases of 4 028 cases, among which 1 case occurred after tonsil ablation and other 36 cases occurred after adenoid ablation. Primary hemorrhage was in 7 cases, while secondary hemorrhage in other 30 cases. Cessation of bleeding was achieved by using different methods of hemostasis in all cases.Conclusion: Tonsil and adenoid ablation were performed by pmRF at low temperature with advantages of less trauma, less bleeding. However, postoperative hemorrhage might occur in a few cases(accounting for 0.92%). Postoperative hemorrhage in these patients was related with preoperatively incomplete control of inflammation of tonsil or adenoid, surgeon's experience, intraoperatively incomplete hemostasis, postoperative crying and restlessness, eating improperly in two weeks after surgery, coagulation factor deficiency. In case of postoperative hemorrhage, good outcome could be achieved by management of compression, pmRF at low temperature, bipolar coagulation.
- plasma-mediated radio-frequency(pmRF) ablation at low temperature /
- sleep apnea hypopnea syndrome,obstructive /
- postoperative hemorrhage

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