Krishna Priya, LaPage Martin J, Hughes Larry F, Lin Sandra Y
Division of Otolaryngology, Southern Illinois University School of Medicine, Springfield, IL, USA.
Int J Pediatr Otorhinolaryngol. 2004 Jun;68(6):779-84. doi: 10.1016/j.ijporl.2004.01.010.
Tonsillectomy is one of the most commonly performed otolaryngologic procedures in the United States. Many options and controversies exist regarding techniques and peri-operative management. The purpose of the study was to examine current practice patterns among otolaryngologists regarding tonsillectomy.
A 13 question survey regarding tonsillectomy techniques and peri-operative management was mailed to 10% of randomly selected board certified otolaryngologists of the AAO-HNS in the spring of 2002. Four hundred and eighteen anonymously completed questionnaires were returned, for a response rate of 58.5%. Statistical analysis of survey data was performed by means of cross tabulation and Pearson Chi-Square Calculation.
Monopolar electrocautery was the most common technique used among those surveyed (53.5%). There was a significant correlation between choice of monopolar electrocautery and the cited reason for choice of technique being decreased blood loss (P < 0.001). There was no relationship between pediatric fellowship training and choice of technique. 97.7% routinely admitted sleep apnea patients for post-operative observation. There was no significant correlation between practice setting (tertiary versus community) and type of post-operative monitoring for sleep apnea patients, with patients most commonly admitted to an intermediate care setting.
In our survey, the most common surgical technique for tonsillectomy was monopolar electrocautery, chosen for the reason of decreased blood loss.
扁桃体切除术是美国最常开展的耳鼻喉科手术之一。在手术技术和围手术期管理方面存在多种选择和争议。本研究的目的是调查耳鼻喉科医生目前在扁桃体切除术方面的实践模式。
2002年春季,一份关于扁桃体切除技术和围手术期管理的包含13个问题的调查问卷被邮寄给随机挑选的美国耳鼻咽喉头颈外科学会(AAO-HNS)10%的获得委员会认证的耳鼻喉科医生。共收到418份匿名填写完整的问卷,回复率为58.5%。通过交叉列表和Pearson卡方计算对调查数据进行统计分析。
在接受调查者中,单极电烙术是最常用的技术(53.5%)。选择单极电烙术与所提及的选择该技术的原因即减少失血之间存在显著相关性(P < 0.001)。儿科专科培训与技术选择之间没有关系。97.7%的医生常规收治睡眠呼吸暂停患者进行术后观察。对于睡眠呼吸暂停患者,执业环境(三级医疗机构与社区医疗机构)与术后监测类型之间没有显著相关性,患者最常被收治到中级护理病房。
在我们的调查中,扁桃体切除术最常用的手术技术是单极电烙术,选择该技术的原因是减少失血。