ภาวะเลือดออกหลังการทำผ่าตัดต่อมทอนซิล ในโรงพยาบาลสมเด็จพระสังฆราชที่องค์ที่ 17

บทคัดย่อ

Introduction : Tonsillectomy with or without adenoidectomy is one of the most frequently performed surgical procedure in otorhinolaryngology. Post-tonsillectomy hemorrhage is recognized as the most serious complication and a potential life-threatening problem.

Objective : For study the result of tonsillectomy and post-tonsillectomy hemorrhage in Somdejprasangkarat 17^th hospital.

Method : This is a descriptive retrospective study of the patients who underwent tonsillectomy with or without adenoidectomy in Somdejprasangkarat 17^th hospital since 1 October 2004 to 31 March 2010.

Result : Total cases were 370 patients, 211 males and 159 females. Tonsillectomy was the most frequently performed in the children (age ranged 2-9 years). Electrocautery dissection was used in all cases. The most common pathological reports were chronic tonsillitis (99.19%). Forty-two patients (11.35%) presented with post-tonsillectomy bleeding. Two patients presented with primary bleeding (bleeding occurred within the first 24 hours) and forty patients with secondary bleeding (bleeding delayed for 5-10 days after surgery). Treatments included observation, surgical procedure and blood transfusion.

Conclusion : In this study, the incidence of post-tonsillectomy bleeding was 11.35%. The important risk factors were patients who were older than 18 year and electrocautery dissection technique. Be careful in the high risk patients and improve surgical technique can reduce post- operative bleeding rate