黎巴嫩扁桃体切除术后出血的患病率及危险因素：一项回顾性研究
Prevalence and Risk Factors of Post-Tonsillectomy Hemorrhage in Lebanon: A Retrospective Study.
文献信息
| PMID | 42747150 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Marwan Saad |
| 作者单位 | Department of Otolaryngology, Hammoud Hospital University Medical Center, Saida, Lebanon. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 确定黎巴嫩一家三级医疗中心扁桃体切除术后出血的患病率并识别相关危险因素。
方法： 纳入2015年1月至2024年12月期间所有接受扁桃体切除术的患者。数据从电子病历中提取。扁桃体切除术后出血定义为有临床记录的术后出血且需要医学评估，并分为原发性（<24小时）或继发性（≥24小时）。使用双变量分析和多变量逻辑回归评估患者相关因素和手术相关因素与扁桃体切除术后出血之间的关联。
结果： 共纳入945例患者（平均年龄8.7岁；85.7%为儿童）。25例患者发生扁桃体切除术后出血，总体患病率为2.65%（95% CI，1.7-3.9）。大多数出血为继发性（92%），通常发生在术后第7天左右。成人出血率显著高于儿童患者（7.4% vs. 1.9%，p=0.001）。成人年龄是扁桃体切除术后出血的唯一独立预测因素（调整比值比2.93，95% CI 1.17-7.36）。未观察到性别、手术时间、手术医生、同期手术、组织病理学发现或常规术前实验室检查值与出血的独立关联。5例患者（20%）需要输血。
结论： 在该黎巴嫩队列中，扁桃体切除术后出血不常见但具有临床意义，以继发性出血为主。成人年龄是主要的独立危险因素，支持需要对成人扁桃体切除术患者加强咨询和术后监测。
英文摘要
OBJECTIVE: To determine the prevalence of post-tonsillectomy hemorrhage and identify associated risk factors in a Lebanese tertiary care center.
METHODS: All patients who underwent tonsillectomy between January 2015 and December 2024 were included. Data were extracted from electronic medical records. Post-tonsillectomy hemorrhage was defined as clinically documented postoperative bleeding requiring medical evaluation and classified as primary (< 24 h) or secondary (≥ 24 h). Associations between patient- and surgery-related factors and post-tonsillectomy hemorrhage were assessed using bivariate analyses and multivariable logistic regression.
RESULTS: A total of 945 patients were included (mean age 8.7 years; 85.7% pediatric). Post-tonsillectomy hemorrhage occurred in 25 patients, yielding an overall prevalence of 2.65% (95% CI, 1.7-3.9). Most hemorrhages were secondary (92%), typically occurring around postoperative day 7. Adults had a significantly higher bleeding rate than pediatric patients (7.4% vs. 1.9%, p = 0.001). Adult age was the only independent predictor of post-tonsillectomy hemorrhage (adjusted odds ratio 2.93, 95% CI 1.17-7.36). No independent associations were observed with sex, operative time, operating surgeon, concurrent procedures, histopathological findings, or routine preoperative laboratory values. Five patients (20%) required blood transfusion.
CONCLUSION: Post-tonsillectomy hemorrhage is uncommon but clinically relevant in this Lebanese cohort, with secondary hemorrhage predominating. Adult age is the primary independent risk factor, supporting the need for enhanced counseling and postoperative surveillance in adult tonsillectomy patients.