肥胖对14 岁以上扁桃体切除术患者 术后出血的影响

Effect of obesity on post-tonsillectomy hemorrhage of patients over 14 years old

摘要:

目的 探讨年龄>14 岁患者扁桃体切除术后出血的发生率，评价与术后再出血相关的危险因 素。方法 选取2012 年8 月—2018 年8 月中南大学湘雅二医院840 例住院行扁桃体切除术的成年患者（年 龄>14 岁）的临床资料，同时采用Logistic 回归模型评估其危险因素。结果 扁桃体切除术后出血发生率 为3.21%（27/840），扁桃体切除术后出血最常发生在手术后的5 或6 d，分别有11 和8 例患者。男性、慢性 阻塞性呼吸暂停综合征、BMI ≥ 30 kg/m2 患者扁桃体切除术后出血发生率更高（P <0.05）。多因素Logistic 回归分析提示，肥胖[Ol ^ R=3.914，（95% CI=1.473，10.401），P =0.006)] 和男性[Ol ^ R=10.331，（95% CI=2.981， 35.8041），P =0.000)] 是扁桃体切除术后出血发生的独立危险因素。结论 肥胖和男性是成人扁桃体切除术后 出血的独立危险因素，在扁桃体切除术前以减轻体重为目的营养方法对于预防术后并发症的发生很有必要。

Abstract:

Objective To investigate the incidence of post-tonsillectomy hemorrhage in patients over 14 years old and to evaluate the risk factors associated with post-tonsillectomy hemorrhage. Methods A total of 840 patients older than 14 who underwent tonsillectomy at the Second Xiangya Hospital of Central South University from August 2012 to August 2018 were included in this retrospective study, and logistic regression model was used to evaluate the risk factors. Results The incidence of post-tonsillectomy hemorrhage was 3.21% (27/840). The most common occurrence of post-tonsillectomy hemorrhage was 5 or 6 days after operation, and there were 11 and 8 patients respectively. The occurrence of post-tonsillectomy hemorrhage was significantly higher in patients matched male, chronic obstructive apnea syndrome and BMI (>30 kg/m2)than others (P < 0.05). Multivariate analysis showed that obesity [Ol ^ R=3.914, (95% CI=1.473,10.401), P = 0.006)] and male [Ol ^ R=10.331, (95% CI=2.981, 35.8041), P = 0.000)] was independent factors affecting the incidence of post-tonsillectomy hemorrhage. Conclusions Our findings suggest that the obese condition is independently associated with the incidence of post-tonsillectomy hemorrhage in adult patients. Weight reduction before tonsillectomy is necessary to prevent complications.