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儿童胆囊疾病发病率上升:20年的视角

The increasing incidence of gallbladder disease in children: A 20year perspective.

作者信息

Murphy Patrick B, Vogt Kelly N, Winick-Ng Jennifer, McClure J Andrew, Welk Blayne, Jones Sarah A

机构信息

Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.

Institute for Clinical Evaluative Sciences, London, ON, Canada.

出版信息

J Pediatr Surg. 2016 May;51(5):748-52. doi: 10.1016/j.jpedsurg.2016.02.017. Epub 2016 Feb 12.

Abstract

OBJECTIVE

The incidence of cholecystectomy in the pediatric population has increased over the last 20years but has not been described in a Canadian population. We conducted the first province-wide study to describe the incidence of cholecystectomy in children in Ontario.

STUDY DESIGN

A population-based, retrospective cohort using administrative databases in Ontario, Canada, was conducted. We included patients less than 18years of age who underwent cholecystectomy from 1993 to 2012. Trends in rates of cholecystectomy were assessed with the Cochrane-Armitage test.

RESULTS

There were a total of 6040 pediatric cholecystectomies performed over the study period in Ontario. The mean age was 14.3years, and 79.6% of patients were females. The crude incidence per 100,000 person-years increased from 8.8 to 13.0 (p<0.001) from 1993 96-2009-12, respectively. The sex-specific incidence showed a larger increase in the female population from 14.7 to 21.1 per 100,000 person-years (p<0.001). The vast majority (82%) of surgeries were performed in 13-17year olds and were largely performed in the community (>75%).

CONCLUSIONS

There has been a significant rise in the incidence of pediatric cholecystectomy in Ontario over the last 20years. The majority of surgeries are performed in the community, and pediatricians will likely see an increase of gallbladder disease in practice.

摘要

目的

在过去20年里,儿科人群中胆囊切除术的发生率有所上升,但加拿大人群中尚未有相关描述。我们开展了首个全省范围的研究,以描述安大略省儿童胆囊切除术的发生率。

研究设计

利用加拿大安大略省的行政数据库进行了一项基于人群的回顾性队列研究。我们纳入了1993年至2012年间接受胆囊切除术的18岁以下患者。采用Cochrane-Armitage检验评估胆囊切除术发生率的趋势。

结果

在研究期间,安大略省共进行了6040例儿科胆囊切除术。平均年龄为14.3岁,79.6%的患者为女性。每10万人年的粗发病率分别从1993 - 1996年的8.8上升至2009 - 2012年的13.0(p<0.001)。按性别划分的发病率显示,女性人群的上升幅度更大,从每10万人年的14.7升至21.1(p<0.001)。绝大多数(82%)手术在13 - 17岁的青少年中进行,且大部分(>75%)在社区完成。

结论

在过去20年里,安大略省儿科胆囊切除术的发生率显著上升。大多数手术在社区进行,儿科医生在实际工作中可能会看到胆囊疾病病例增加。

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