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腺样体扁桃体切除术后体重增加在幼儿中更为常见。

Weight gain after adenotonsillectomy is more common in young children.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.

出版信息

Otolaryngol Head Neck Surg. 2013 Mar;148(3):488-93. doi: 10.1177/0194599812473412. Epub 2013 Jan 16.

Abstract

OBJECTIVE

Adenotonsillectomy (TA), performed for obstructive sleep apnea (OSA) or recurrent tonsillitis (RT), has been associated with weight gain after surgery. The objective of this study was to look at a large population of children undergoing TA and the demographic factors that contribute to postoperative weight gain.

STUDY DESIGN

Case series with retrospective chart review.

SETTING

Tertiary, urban academic care center.

SUBJECTS AND METHODS

Children undergoing TA at an academic center between 2008 and 2011 were included in this study. Demographic data (age, gender, race), OSA disease severity, preoperative and 3- to 6-month postoperative normalized body mass index (BMI; z-scores), and changes in z-scores were compared.

RESULTS

Complete weight data after TA were available for 115 children, 85 of whom underwent surgery for OSA. Mean age (7.2 ± 4.3 vs 7.3 ± 4.4 years, P = .955) and gender distribution (38% female vs 50% male; P = .323) were similar for the OSA and RT groups. However, children with OSA were more likely to be black (60% vs 33%) than RT patients (P = .026). Overall, the preoperative BMI z-score increased from 0.98 ± 1.50 to 1.21 ± 1.25 (P = .0009) with no difference by surgical indication (P = .58). Multiple linear regression analysis demonstrated that only age was significantly, and negatively, associated with changes in BMI z-scores (P = .015).

CONCLUSIONS

Similar to previous studies, children had weight gain after TA. In this analysis, younger age (≤ 6 years) was a significant predictor of postoperative weight gain. Future research should prospectively evaluate the association between weight gain and demographic factors in children undergoing TA, with special attention to the relationship with age.

摘要

目的

腺样体扁桃体切除术(TA)用于治疗阻塞性睡眠呼吸暂停(OSA)或复发性扁桃体炎(RT),与术后体重增加有关。本研究的目的是观察接受 TA 的大量儿童以及导致术后体重增加的人口统计学因素。

研究设计

病例系列,回顾性图表审查。

地点

三级城市学术护理中心。

受试者和方法

本研究纳入了 2008 年至 2011 年期间在学术中心接受 TA 的儿童。比较了人口统计学数据(年龄、性别、种族)、OSA 疾病严重程度、术前和 3 至 6 个月后的体重指数(BMI;z 评分)以及 z 评分的变化。

结果

共有 115 名儿童的 TA 后完整体重数据可用,其中 85 名儿童因 OSA 接受手术。OSA 和 RT 组的平均年龄(7.2 ± 4.3 岁比 7.3 ± 4.4 岁,P =.955)和性别分布(38%女性比 50%男性,P =.323)相似。然而,患有 OSA 的儿童比 RT 患者更有可能是黑人(60%比 33%),差异有统计学意义(P =.026)。总体而言,术前 BMI z 评分从 0.98 ± 1.50 增加到 1.21 ± 1.25(P =.0009),手术指征无差异(P =.58)。多元线性回归分析表明,只有年龄与 BMI z 评分的变化呈显著负相关(P =.015)。

结论

与先前的研究类似,儿童在接受 TA 后体重增加。在本分析中,年龄较小(≤ 6 岁)是术后体重增加的显著预测因素。未来的研究应前瞻性评估接受 TA 的儿童中体重增加与人口统计学因素之间的关系,特别关注与年龄的关系。

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