山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (5): 67-69.doi: 10.6040/j.issn.1673-3770.0.2021.019

• • 上一篇    下一篇

可调式支撑喉镜辅助治疗难治性扁桃体术后出血

冯世强,姜宪   

  1. 延边大学附属医院 耳鼻咽喉头颈外科, 吉林 延吉 133000
  • 发布日期:2021-09-29
  • 通讯作者: 姜宪. E-mail:jiangxian@yub.edu.cn

Adjunctive treatment of refractory by adjustable laryngoscope Hemorrhage after tonsillectomy

FENG Shiqiang, JIANG Xian   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji 13300, Jilin, China
  • Published:2021-09-29

摘要: 目的 用可调式支撑喉镜辅助治疗由常规开口器难以处理的扁桃体术后出血,为临床提供更便捷的治疗手段。 方法 对11例扁桃体切除术后出血患者,因出血点暴露不清,改以可调式支撑喉镜辅助查找出血点并进行止血。 结果 可调式支撑喉镜视野清晰,充分地暴露隐蔽而深在的出血点,可快速止血,明显缩短在院观察时间。 结论 可调式支撑喉镜用来辅助查找扁桃体术后出血点是可靠的方法,尤其适用于位置移深、出血点暴露不清的扁桃体创面出血,为治疗扁桃体术后出血提供可选方式。

关键词: 支撑喉镜, 扁桃体, 术后出血, 难治性

Abstract: Objective To provide a more convenient treatment method for tonsillar hemorrhage that is difficult to handle by conventional openers. Methods Eleven patients with bleeding after tonsillectomy were changed to an adjustable supporting laryngoscope to assist in finding the bleeding point to stop bleeding because the bleeding point was not clearly exposed. Results the adjustable laryngoscope had clear vision, fully exposed the hidden and deep bleeding points, which could quickly stop bleeding and significantly shorten the observation time in hospital. Conclusion the adjustable laryngoscope is a reliable method to find the bleeding point after tonsillectomy, especially for the difficult tonsillar wound bleeding which is very hidden and deep under the tonsil, and provides an optional method for the treatment of postoperative bleeding of tonsil.

Key words: Laryngoscope, Tonsil, Postoperative bleeding, Intractable

中图分类号: 

  • R767
[1] 窦艳玲, 冯怀志, 刘涛, 等. 减少扁桃体手术出血的手术技巧[J]. 西南国防医药, 2010, 20(11): 1172.
[2] 孙宝春, 王丰, 杨淑芝, 等. 低温等离子辅助下儿童腺样体、扁桃体手术并发症分析[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(22): 1720-1723. doi:10.13201/j.issn.1001-1781.2017.22.004. SUN Baochun, WANG Feng, YANG Shuzhi, et al. Complications analysis of adenoidectomy and tonsillectomy assisted with ablation on children[J]. Journal of Clinical Otorhinolaryngology Head & Neck Surgery, 2017, 31(22): 1720-1723. doi:10.13201/j.issn.1001-1781.2017.22.004.
[3] 叶钰华, 王智楠, 徐忠强. 儿童低温等离子扁桃体切除术后迟发性出血的原因分析[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(6): 528-531. doi:10.13201/j.issn.1001-1781.2015.06.013. YE Yuhua, WANG Zhinan, XU Zhiqiang. Analysis of the causes of postoperative delayed hemorrhage of low temperature lasma tonsillectomy in children[J]. J Clin Otorhinolaryngol Head Neck Surg, 2015, 29(6): 528-531. doi:10.13201/j.issn.1001-1781.2015.06.013.
[4] Söderman AC, Odhagen E, Ericsson E, et al. Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis. An analysis of 15734 patients in the National Tonsil Surgery Register in Sweden[J]. Clin Otolaryngol, 2015, 40(3): 248-254. doi:10.1111/coa.12361.
[5] Aksoy EA, Serin GM, Polat S, et al. Comparison of postoperative bleeding between submucosal uvulopalatopharyngoplasty and tonsillectomy[J]. J Res Med Sci, 2014, 19(4): 310-313.
[6] 蔡朝阳, 郑刚, 许小龙. 扁桃体电切术后出血分度与相关因素研究[J]. 中国医药导报, 2014, 11(8): 62-65. CAI Zhaoyang, ZHENG Gang, XU Xiaolong. Study of maginitude and related factors of post-tonsillectomy hemorrhage by high-frequency electric surgical knife[J]. China Medical Herald, 2014, 11(8): 62-65.
[7] 易星, 邓腾波. 扁桃体低温等离子融切术后出血的相关危险因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(5): 407-410. doi:10.13201/j.issn.1001-1781.2019.05.006. YI Xing, DENG Tengbo. Analysis of risk factors for postoperative haemorrhage following coblation-assisted tonsillectomy[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(5): 407-410. doi:10.13201/j.issn.1001-1781.2019.05.006.
[8] 隋海晶, 肖水芳, 秦永, 等. 等离子射频辅助的悬雍垂腭咽成形术后出血的临床研究[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(10): 830-834. doi:10.3760/cma.j.issn.1673-0860.2010.10.011. SUI Haijing, XIAO Shuifang, QIN Yong, et al. Study on hemorrhage following coblation assisted uvulopalatopharyng-oplasty[J]. China Journal Otorhinolaryngol Head Neck Surg, 2010, 45(10): 830-834. doi:10.3760/cma.j.issn.1673-0860.2010.10.011.
[9] 董世亮, 战明明. “预防性缝扎法”在扁桃体切除术中的止血效果[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 90-91. doi:10.6040/j.issn.1673-3770.0.2015.282. DONG Shiliang, ZHAN Mingming. Hemostatic effect of preventive suture ligation in tonsillectomy[J]. Journal Otolaryngol Ophthalmol Shandong Univ, 2015, 29(6): 90-91. doi:10.6040/j.issn.1673-3770.0.2015.282.
[10] 田天捷, 张自雄, 杨飞, 等. 缝合腭弓对扁桃体术后出血影响的临床研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 82-85. doi:10.6040/j.issn.1673-3770.0.2020.114. TIAN Tianjie, ZHANG Zixiong, YANG Fei, et al. Effects of palatal arch suturing on postoperative hemorrhage after tonsillectomy[J]. Journal Otolaryngol Ophthalmol Shandong Univ, 2021, 35(1): 82-85. doi:10.6040/j.issn.1673-3770.0.2020.114.
[11] Gratacap M, Couloigner V, Boulouis G, et al. Embolization in the management of recurrent secondary post-tonsillectomy haemorrhage in children[J]. European Radiology, 2015, 25(1): 239-245. doi:10.1007/s00330-014-3387-3.
[12] Walijee H, Krishnan M, Sharma R, et al. Indirect visualisation of the upper pole during tonsillectomy[J]. Journal of Laryngology & Otology, 2018, 132(5): 461-462. doi:10.1017/S0022215118000312.
[13] Alon EE, Wolf M. Instrumentation in endoscopic laryngeal surgery[J]. Operative Techniques in Otolaryngology-Head and Neck Surgery, 2019, 30(4): 243-248. doi:10.1016/j.otot.2019.09.004.
[14] 李树华, 石洪金, 吴大海, 等. 可视喉镜等离子系统切除会厌舌根良性病变71例[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 53-57. doi:10.6040/j.issn.1673-3770.0.2016.118. LI Shuhua, SHI Hongjin, WU Dahai, et al. Resection of benign gloss-epiglottis lesions assisted with video laryngoscope and radiofrequency ablation system: a; report of 71 cases[J]. Journal Otolaryngol Ophthalmol Shandong Univ, 2016, 30(6): 53-57. doi:10.6040/j.issn.1673-3770.0.2016.118.
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