Albertz Nicolas, Nazar Gonzalo
Public Health Department, Clinica Las Condes, University of Chile, Santiago, Chile.
Acta Otolaryngol. 2012 Oct;132(10):1102-7. doi: 10.3109/00016489.2012.684399. Epub 2012 Jun 18.
Immediate tonsillectomy in patients with peritonsillar abscess is a safe and effective treatment that should be considered as an alternative to conventional incision and drainage.
To assess the efficacy, safety, and microbiology of immediate tonsillectomy over 10 years, in patients with peritonsillar abscess.
This was a retrospective study. We reviewed the clinical charts of patients diagnosed with peritonsillar abscess in Clínica Las Condes from September 2000 to August 2010, who were treated with immediate unilateral or bilateral tonsillectomy. The patients' epidemiological information, antibiotic therapy, laterality of the surgery, results of microbiological cultures, complications, and recurrences were recorded.
A total of 112 patients were studied, with a mean age of 24 years. There were no events of sepsis, and there were only four cases (3.6%) of postoperative bleeding, two of which resolved spontaneously. Only 29% of the patients required morphine pump-based analgesia in the postoperative period. The mean length of hospital stay was 3.4 days. Among the 28 unilateral tonsillectomies, 4 (14.2%) developed streptococcal tonsillitis and 2 (7.1%) were readmitted with a contralateral peritonsillitis: one cellulitis and one abscess that required drainage and tonsillectomy. The most frequently isolated microorganisms were gram-positive bacteria (Streptococcus pyogenes and other streptococci) and anaerobic bacteria (mainly Bacteroides spp. and Fusobacterium nucleatum).
对于扁桃体周脓肿患者，即刻扁桃体切除术是一种安全有效的治疗方法，应被视为传统切开引流术的替代方案。
评估即刻扁桃体切除术在10年期间对扁桃体周脓肿患者的疗效、安全性及微生物学情况。
这是一项回顾性研究。我们回顾了2000年9月至2010年8月在拉斯孔德斯诊所被诊断为扁桃体周脓肿且接受即刻单侧或双侧扁桃体切除术的患者的临床病历。记录了患者的流行病学信息、抗生素治疗情况、手术侧别、微生物培养结果、并发症及复发情况。
共研究了112例患者，平均年龄24岁。未发生败血症事件，术后出血仅4例（3.6%），其中2例自行缓解。术后仅29%的患者需要使用吗啡泵镇痛。平均住院时间为3.4天。在28例单侧扁桃体切除术中，4例（14.2%）发生链球菌性扁桃体炎，2例（7.1%）因对侧扁桃体周炎症再次入院：1例蜂窝织炎和1例脓肿，需行引流及扁桃体切除术。最常分离出的微生物是革兰氏阳性菌（化脓性链球菌和其他链球菌）和厌氧菌（主要是拟杆菌属和具核梭杆菌）。
