Hemorrhage risk after coblation tonsillectomy in Chinese pediatric: a multicenter, prospective, observational cohort study

被引：0

作者：

Hongming Xu ^{[1
]}

Shuyao Qiu ^{[2
]}

Jinxia Wang ^{[3
]}

Fugen Han ^{[4
]}

Zhongfang Xia ^{[5
]}

Liyan Ni ^{[6
]}

Jing Ma ^{[7
]}

Chunguang Chen ^{[8
]}

Xingqiang Gao ^{[9
]}

Junmei Zhang ^{[10
]}

Haixia Liu ^{[11
]}

Haibing Liu ^{[12
]}

Hongbing Yao ^{[13
]}

Qianger Zhuang ^{[14
]}

Wei Song ^{[15
]}

Sijun Zhao ^{[16
]}

Dabo Liu ^{[2
]}

Xiaoyan Li ^{[1
]}

机构：

[1] Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, No.355, Luding Road, Shanghai

[2] Department of Pediatric Otorhinolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen

[3] Clinical Research Unit, School of Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai

[4] Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children’s Hospital of Zhengzhou University/Henan Children’s Hospital/Zhengzhou Children’s Hospital, Zhengzhou

[5] Department of Otorhinolaryngology Head and Neck Surgery, Wuhan Children’s Hospital, Wuhan

[6] Department of otolaryngology head and neck surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou

[7] Department of Otorhinolaryngology Head and Neck Surgery, Kunming Children’s Hospital, Kunming

[8] Department of Otorhinolaryngology Head and Neck Surgery, Anyang Maternal and Child Health Hospital, Anyan

[9] Department of Otorhinolaryngology Head and Neck Surgery, Xiamen Children’s Hospital, Xiamen

[10] Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Children’s Hospital, Tianjin

[11] Department of Otorhinolaryngology, Shanxi Children’s Hospital Shanxi Maternal and Child Health Hospital, Shanxi

[12] Department of Otorhinolaryngology Head and Neck Surgery, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu

[13] Ministry of Education Key Laboratory of child Development and Disorders. Chongqing Key laboratory of Structural Birth defect and Reconstruction, Department of Otorhinolaryngology Head and Neck Surgery, National Clinical research Center for Child Health and

[14] Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Children’s Hospital of Jiangnan University (Wuxi Children’s Hospital), Wuxi, Jiangsu

[15] Department of Otorhinolaryngology Head and Neck Surgery, Dalian Women and Children’s Medical Group, Dalian

[16] Department of Otorhinolaryngology Head and Neck Surgery, Hunan Children’s Hospital, Changsha

来源：

European Archives of Oto-Rhino-Laryngology | 2025年 / 282卷 / 4期

基金：

中国国家自然科学基金;

关键词：

Coblation; Multicentre; Pediatric; Post-coblation tonsillectomy hemorrhage; Tonsillectomy;

D O I：

10.1007/s00405-024-09140-8

中图分类号：

学科分类号：

摘要：

Objectives: The study aimed to assess the incidence of post-coblation tonsillectomy hemorrhage (PCTH) and identify associated risk factors in a pediatric Chinese population. Methods: This prospective, multicenter cohort study, conducted over 17 months, included 8854 pediatric patients who underwent coblation tonsillectomy across 15 research centers in China. Patient data were collected through an Electronic Data Capture (EDC) system. The primary outcome was the incidence of PCTH within 21 days post-surgery. Secondary outcomes involved analyzing risk factors for PCTH using multivariable logistic regression. Results: The incidence of PCTH was 1.99%, with 176 patients experiencing hemorrhage. Significant risk factors included abnormal coagulation indicators (OR 10.56), longer surgery duration (OR 1.02), simultaneous adenoidectomy (OR 0.35), semi-liquid diet (OR 0.13), postoperative cough (OR 1.76), and the use of hemostatic agents (OR 1.58), intravenous antibiotics (OR 2.34), and painkillers (OR 2.33). Regional variations showed lower hemorrhage rates in East, Southwest, Central, and South China compared to North China. Conclusions: The study found that the hemorrhage rate after coblation tonsillectomy is comparable to traditional tonsillectomy. Risk factors include coagulation status, surgical duration, and postoperative care. Regional differences in hemorrhage rates suggest the need for tailored approaches based on location. Coblation tonsillectomy is a safe and effective procedure for pediatric patients. Trial registration number and date of registration for prospectively registered trials: This study was registered on Clinical trials.gov (NCT05206799), and approved by the Ethics Committee of Shanghai Children’s Hospital, Shanghai Jiaotong University (2021R096-E01). © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.

引用

页码：1901 / 1909

页数：8

共 32 条

[21] Franco R.J., Rosenfeld R.M., Rao M., First place–resident clinical science award 1999. Quality of life for children with obstructive sleep apnea[J], Otolaryngol Head Neck Surg, 123, 1 Pt 1, pp. 9-16, (2000)
[22] Brodsky L., Modern assessment of tonsils and adenoids[J], Pediatr Clin North Am, 36, 6, pp. 1551-1569, (1989)
[23] Windfuhr J., Seehafer M., Classification of haemorrhage following tonsillectomy[J], J Laryngol Otol, 115, 6, pp. 457-461, (2001)
[24] Francis D.O., Chinnadurai S., Sathe N.A., Et al., Tonsillectomy for Obstructive Sleep-Disordered Breathing or Recurrent Throat Infection in Children[M], Rockville (Md):Agency for Healthcare Research and Quality, (2017)
[25] Francis D.O., Fonnesbeck C., Sathe N., Et al., Postoperative Bleeding and Associated Utilization following Tonsillectomy in Children[J], Otolaryngol Head Neck Surg, 156, 3, pp. 442-455, (2017)
[26] Manning S.C., Beste D., Mcbride T., Et al., An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy[J], Int J Pediatr Otorhinolaryngol, 13, 3, pp. 237-244, (1987)
[27] Krishna P., Lee D., Post-tonsillectomy bleeding: a meta-analysis[J], Laryngoscope, 111, 8, pp. 1358-1361, (2001)
[28] Koizumi M., Ishimaru M., Matsui H., Et al., Tranexamic acid and post-tonsillectomy hemorrhage: propensity score and instrumental variable analyses[J], Eur Arch Otorhinolaryngol, 276, 1, pp. 249-254, (2019)
[29] Spektor Z., Saint-Victor S., Kay D.J., Et al., Risk factors for pediatric post-tonsillectomy hemorrhage[J], Int J Pediatr Otorhinolaryngol, 84, pp. 151-155, (2016)
[30] Danielides V., Nousia C.S., Patrikakos G., Et al., Effect of meteorological parameters on acute laryngitis in adults[J], Acta Otolaryngol, 122, 6, pp. 655-660, (2002)

← 1 2 3 4 →