title: [Analysis of the causes of immediate bleeding after pediatric adenoidectomy].
abstract: OBJECTIVE
  To evaluate the incidence of postoperative hemorrhage in children undergoing adenoidectomy, and to discuss its possible causes.
  
  
  METHODS
  Included in this study were children who underwent adenoid and/or tonsil surgery at Shenzhen Children's Hospital between January 2004 and November 2009. The change of hemoglobin (Hb) and hematocrit (Hct) were retrospectively analysed. The blood loss was estimated by the change of Hct.
  
  
  RESULTS
  There were 2078 cases that accomplished the inclusion criteria in the period of study. Ten children bled 0.5 - 4.0 hours after surgery, without superfluous hemorrhage during the operation and post-tonsillectomy. This represented an incidence of 0.48%of immediate postoperative haemorrhage among the 2078 procedures analyzed. Statistical differences were found between boys (0.21%) and girls (1.10%, χ² = 5.597, P < 0.05). The change of Hb and Hct was positively correlated (r = 0.95, P < 0.01), the blood loss was positively correlated with the bleeding time (r = 0.66, P < 0.05). The causes of postoperative hemorrhage were coagulation system deficits, chronic nasopharyngitis, deficient hemostasis and immoderate ravage. To control the postoperative hemorrhage, 2 postnasal packing under topical anaesthesia and 8 electrocautery under general anaesthesia were applied.
  
  
  CONCLUSIONS
  Poor operative technique and deficient hemostasis are the major causes of primary hemorrhage. Prompt operation to control the postoperative bleeding should be done 2 hours after bleeding under general anesthesia in order to avoid severe complications.
authors.affiliation: Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen 518026, China.
authors.forename: Hong-guang
authors.initials: HG
authors.lastname: Pan
authors.forename: Lan
authors.initials: L
authors.lastname: Li
authors.forename: Yong-tian
authors.initials: YT
authors.lastname: Lu
authors.forename: De-lun
authors.initials: DL
authors.lastname: Zhang
authors.forename: Xiang-yu
authors.initials: XY
authors.lastname: Ma
authors.forename: Zhi-xiong
authors.initials: ZX
authors.lastname: Xian
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008297:Male; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000009:adverse effects
chemical_list: D006454:Hemoglobins