摘要
目的探讨低温等离子辅助的H-UPPP术治疗成人OSAHS术后出血的原因,提出预防措施。方法回顾性分析我院2015年6月~2019年6月确诊的228例OSAHS患者在全身麻醉下使用美国Arthrocare公司的ENT ColatorⅡ等离子手术系统行改良悬雍垂腭咽成形(H-UPPP)术,观察术后出血情况。结果228例患者中11例出现术后出血,其中术后24h内2例,术后7~14d 9例。继发性出血发生率高于原发性出血发生率,无失血性休克等危及生命的严重并发症,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,术后恢复快,但仍有极少数患者(4.82%)术后出血。原因与术者使用等离子的操作经验、术后2周内进食不当影响创面恢复密切相关。在围术期的健康宣教、治疗和管理,以及手术中精准操作、彻底完善止血是减少术后出血的重要措施。
Objective To investigate the causes of hemorrhage in low-temperature plasma-assisted H-UPPP in the treatment of adult obstructive sleep apnea-hypopnea syndrome(OSAHS),and to propose preventive measures.Methods A total of 228 OSAHS patients diagnosed in our hospital from June 2015 to June 2019 undergoing general anesthesia using the ENT ColatorⅡPlasma Surgery System of Arthrocare Company in the United States for modified uvulopalatopharyngoplasty(H-UPPP)were retrospectively analyzed.The postoperative bleeding was observed.Results Postoperative bleeding occurred in 11 of the 228 patients,including 2 within 24 hours and 9 in 7 to 14 days.The incidence rate of secondary bleeding was higher than that of primary bleeding,and there were no serious life-threatening complications such as hemorrhagic shock.The bleeding stopped after different methods.Conclusion Low-temperature plasma radiofrequency ablation features less trauma,less intraoperative bleeding,and faster postoperative recovery.However,there are still a very small number of patients(4.82%)with postoperative hemorrhage,which is closely related to the operation experience of the operator using plasma,and the improper feeding within 2 weeks after surgery affecting the wound healing.Perioperative treatment,education and care,adequate intraoperative hemostasis,and precise operation are the keys to reducing postoperative bleeding.
作者
王桂芳
谢红冠
宋洋
WANG Guifang;XIE Hongguan;SONG Yang(Department of Otorhinolaryngology,the 926th Hospital of the Chinese PLA,Yunnan,Kaiyuan 661600,China)
出处
《中国医药科学》
2020年第11期247-249,253,共4页
China Medicine And Pharmacy
