局部应用富血小板血浆能减少扁桃体切除术后出血吗?比较研究

Ahmed Muhei Rasheed
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引用次数: 0

摘要

背景:扁桃体切除术是耳鼻喉科最常见的手术之一,扁桃体切除术后出血是一种危险的并发症。为了降低扁桃体切除术后出血的发生率,已有几种方法被采用,其中一种较新的方法是在扁桃体床上局部应用富血小板血浆(PRP)。目的:评价扁桃体切除术时扁桃体床局部应用自体PRP在扁桃体切除术后出血中的作用。患者和方法:一项前瞻性比较研究纳入了64例年龄在6至10岁之间的患者,他们接受了扁桃体切除术和腺样体切除术。在每位患者中,在扁桃体切除术时将PRP应用于一侧扁桃体床(PRP侧),而另一侧作为对照侧。因此,总侧数为128(64个PRP侧和64个对照侧)。随访10天,观察结果为PRP侧与对照组扁桃体切除术后出血的发生情况。采用卡方检验(x2检验)建立各变量之间的相关性。结果:男性38例(59.4%),女性26例(40.6%)。35例(54.7%)患者行腺扁桃体切除术,29例(45.3%)患者行单纯扁桃体切除术。术后腺样体床无出血。扁桃体切除术后出血PRP侧1例(1.6%),对照侧3例(4.7%)(p值=0.31)。结论:扁桃体切除术时仅在扁桃体床上局部应用一次自体PRP,对减少扁桃体切除术后出血效果不显著。收稿日期:2023年6月录用日期:2023年7月发表日期:2023年10月
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Does the local application of Platelet-Rich Plasma Reduce Hemorrhage after Tonsillectomy? A Comparative Study
Background: Tonsillectomy is one of the most common surgical operations in otolaryngology, post-tonsillectomy hemorrhage is a dangerous complication. Several methods have been used to decrease the rate of post-tonsillectomy hemorrhage, one of these methods, a relatively recent method, is local application of platelet-rich plasma (PRP) to the tonsillar beds. Objectives: To evaluate the role of local application of autologous PRP to the tonsillar beds, at the time of tonsillectomy, in post-tonsillectomy hemorrhage. Patients and methods: A prospective comparative study enrolled 64 patients with ages ranging from 6 to 10 years who underwent tonsillectomy with or without adenoidectomy. In each patient, PRP was applied at the time of tonsillectomy to one tonsillar bed (PRP side), while the other side was used as a control side. So, the total sides were 128 (64 PRP and 64 control sides). The patients were followed-up for 10 days and the outcome measure was the occurrence of post-tonsillectomy hemorrhage on the PRP side versus the control side. The association between the variables was established using chi-square test (X2-test). Results: Thirty-eight patients (59.4%) were males and twenty-six patients (40.6%) were females. Adenotonsillectomy was performed in 35 patients (54.7%), while 29 patients (45.3%) underwent tonsillectomy alone. There was no post-operative hemorrhage from the adenoid beds. Post-tonsillectomy hemorrhage occurred in 1 patient (1.6%) on the PRP side and 3 patients (4.7%) on the control side (P-value=0.31). Conclusions: The local application of autologous PRP to the tonsillar bed only once, at the time of tonsillectomy, is not significantly effective in reducing post-tonsillectomy hemorrhage. Received: Jun. 2023 Accepted: July, 2023 Published: Oct .2023
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