Doganer Yusuf C, Rohrer James E, Aydogan Umit, Thurston McKennan J, Saglam Kenan
Department of Family Medicine, Turkish Military Academy, Primary Care Examination Center, Ankara, Turkey; Department of Family Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Family Medicine, Mayo Clinic, Rochester, MN, USA.
Int J Pediatr Otorhinolaryngol. 2015 Jul;79(7):969-74. doi: 10.1016/j.ijporl.2015.03.005. Epub 2015 Mar 14.
The present study sought to investigate the frequencies of tonsillectomy, adenoidectomy and both adenotonsillectomy (T&A) among 6-12 years old children. In addition, we tried to find out the predictors associated with these previous upper respiratory tract (URT) surgeries.
This cross-sectional study consisted of 1900 children educated in 3 different elementary schools in Ankara, Turkey. Data about demographics and health conditions were obtained from survey questionnaires completed by parents.
Of the 1900 children, 15 children (0.8%) previously underwent tonsillectomy, 43 children (2.3%) had adenoidectomy and 80 children (4.2%) had T&A surgical histories. Multiple logistic regression analysis revealed that older students compared to younger ones [odds ratio (OR) = 1.15, p = 0.011], and those who had parent-reported apnea compared to subjects without apnea were more likely to have URT surgery histories [OR = 2.34, p = 0.001]. Those children with surgery histories were more likely to have fathers with a higher educational level [medium level: OR = 2.07, p = 0.012; high level: OR = 2.79, p = 0.001 vs. low level) and the subjects had greater BMI percentiles [overweight: OR = 1.71, p = 0.036; obesity: OR = 2.32, p = 0.003 vs. healthy weight]. Children who had 1-2 URT infections per year [OR = 0.47, p = 0.019] had less probability of URT surgery histories, whereas those children with AOM ≥ 3 times per year [OR = 2.52, p = 0.003] had more probability of URT surgery history.
We conclude that a reasonable explanation for higher rates of URT surgery among children with a high level of paternal education may originate from their awareness about URT associated diseases and possibly due to the ease of access to health care services.
本研究旨在调查6至12岁儿童扁桃体切除术、腺样体切除术以及扁桃体腺样体切除术（T&A）的频率。此外，我们试图找出与这些既往上呼吸道（URT）手术相关的预测因素。
这项横断面研究由在土耳其安卡拉3所不同小学就读的1900名儿童组成。有关人口统计学和健康状况的数据通过家长填写的调查问卷获得。
在1900名儿童中，15名儿童（0.8%）既往接受过扁桃体切除术，43名儿童（2.3%）接受过腺样体切除术，80名儿童（4.2%）有T&A手术史。多因素logistic回归分析显示，年龄较大的学生与年龄较小的学生相比[比值比（OR）=1.15，p = 0.011]，以及家长报告有呼吸暂停的儿童与无呼吸暂停的儿童相比，更有可能有URT手术史[OR = 2.34，p = 0.001]。有手术史的儿童更有可能有受教育程度较高的父亲[中等水平：OR = 2.07，p = 0.012；高水平：OR = 2.79，p = 0.001 vs.低水平]，并且这些儿童的BMI百分位数更高[超重：OR = 1.71，p = 0.036；肥胖：OR = 2.32，p = 0.003 vs.健康体重]。每年有1至2次URT感染的儿童[OR = 0.47，p = 0.019]有URT手术史的可能性较小，而每年患急性中耳炎（AOM）≥3次的儿童[OR = 2.52，p = 0.003]有URT手术史的可能性更大。
我们得出结论，父亲受教育程度高的儿童URT手术率较高的一个合理解释可能源于他们对URT相关疾病的认识，也可能是由于获得医疗服务的便利性较高。
