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学龄儿童扁桃体切除术、腺样体切除术及腺样体扁桃体切除术的发生率:社会人口统计学和临床特征的相对影响

Tonsillectomy, adenoidectomy and adenotonsillectomy rates in school-aged children: Relative contributions of socio-demographic and clinical features.

作者信息

Doganer Yusuf C, Rohrer James E, Aydogan Umit, Thurston McKennan J, Saglam Kenan

机构信息

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.

出版信息

Int J Pediatr Otorhinolaryngol. 2015 Jul;79(7):969-74. doi: 10.1016/j.ijporl.2015.03.005. Epub 2015 Mar 14.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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