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儿童日间扁桃体切除术:家长态度与咨询率

Day-case tonsillectomy in children: parental attitudes and consultation rates.

作者信息

Kanerva Mervi, Tarkkila Pekka, Pitkäranta Anne

机构信息

Department of Otorhinolaryngology, University Hospital of Helsinki, POB 220, FIN-00029, Hus, Finland.

出版信息

Int J Pediatr Otorhinolaryngol. 2003 Jul;67(7):777-84. doi: 10.1016/s0165-5876(03)00097-1.

Abstract

OBJECTIVE

In Europe, the day-case tonsillectomy rate in children is slowly increasing, but whether parents really want this rapid discharge of their child is questionable. The fear is that aftercare might fall solely on community care. The aim of this prospective study was to introduce pediatric day-case tonsillectomy to our hospital and to determine parents' attitudes to this procedure. The other interest centered on consultation rates within the 2-week recovery period.

METHODS

One hundred children aged 3-16 years had day-case tonsillectomy (38) or adenotonsillectomy (62). Peri-operative and post-operative complications were recorded. Parents were phoned the next day and 1-4 months after the operation. Parents' opinions of day-case surgery and consultations with healthcare professionals during the 2-week recovery period were recorded.

RESULTS

Ninety children went home the day of the operation. Vomiting was the most frequent complication. No primary hemorrhages occurred. Called the next day, 100% of parents felt that their children were better served spending their first night at home as compared with staying in hospital. Called 1-4 months later, 94.5% of parents still thought this way. In the 2-week recovery period following the tonsillectomy, 13% of patients visited a physician and 17% called for information. These numbers include patients with secondary hemorrhage. If these are excluded, 5% of patients visited a physician and 13% called for advice. Children were taken back to hospital only due to secondary hemorrhage.

CONCLUSIONS

Most parents considered day-case tonsillectomy to be suitable for their family. Consultation rates were low. Careful patient selection and adequate pre-operative information are prerequisites for day-case tonsillectomy.

摘要

目的

在欧洲,儿童日间扁桃体切除术的比例正在缓慢上升,但家长是否真的希望孩子能如此迅速出院仍值得怀疑。人们担心术后护理可能完全依赖社区护理。这项前瞻性研究的目的是在我们医院引入儿童日间扁桃体切除术,并确定家长对该手术的态度。另一个关注点是两周康复期内的咨询率。

方法

100名3至16岁的儿童接受了日间扁桃体切除术(38例)或腺样体扁桃体切除术(62例)。记录围手术期和术后并发症。术后第二天以及术后1至4个月给家长打电话。记录家长对日间手术的看法以及在两周康复期内与医护人员的咨询情况。

结果

90名儿童术后当天回家。呕吐是最常见的并发症。未发生原发性出血。术后第二天打电话时,100%的家长认为孩子在家度过第一个晚上比住院更好。术后1至4个月打电话时,94.5%的家长仍持这种观点。在扁桃体切除术后的两周康复期内,13%的患者看了医生,17%的患者打电话咨询。这些数字包括有继发性出血的患者。如果排除这些患者,5%的患者看了医生,13%的患者打电话咨询。孩子仅因继发性出血被带回医院。

结论

大多数家长认为日间扁桃体切除术适合他们的家庭。咨询率较低。仔细的患者选择和充分的术前信息是日间扁桃体切除术的前提条件。

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