Kuo Ho-Chang, Yang Ya-Ling, Ho Shu-Chen, Guo Mindy Ming-Huey, Jiang Jyun-Hong, Huang Ying-Hsien
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Taiwan University Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung Department of Public Health, College of Health Sciences, Kaohsiung Medical University Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Medicine (Baltimore). 2016 Jul;95(28):e4269. doi: 10.1097/MD.0000000000004269.
General anesthesia (GA) has been used for second line treatment strategy for status asthmaticus in pediatric patients. The association between GA in children and risk of followed-up allergic diseases is unclear. This study aims to assess the risk of allergic diseases after GA in children.We did a nationwide retrospective cohort study by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. The subsequent risks for allergic diseases, including asthma (ICD-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477.X), and atopic dermatitis (AD; ICD-9-CM code 691.X), were compared between exposure to GA and none before 1 year of age throughout the follow-up period using the Cox proportional hazards model.Insurance claims data for 32,742 children younger than 1 year old from all insured children in the NHIRD. Of those, 2358 subjects were exposed to GA; 414 and 1944 children exposed to mask and intubation ventilation, respectively, served as the study cohort, whereas the remaining 30,384 children made up the comparison cohort. Children in the GA group were at a lower risk of developing asthma, AR and AD, with adjusted hazard ratios of 0.67 (0.62-0.72, 95%CI), 0.72 (0.68-0.77, 95%CI), 0.60 (0.56-0.64, 95%CI), respectively.Children who were exposed to GA in early life before 1 year of age had reduced risk of subsequently developing allergic diseases such as asthma, AD, and AR, when compared with general population.
全身麻醉（GA）已被用于小儿重症哮喘的二线治疗策略。儿童全身麻醉与后续过敏性疾病风险之间的关联尚不清楚。本研究旨在评估儿童全身麻醉后发生过敏性疾病的风险。
我们通过分析台湾国民健康保险研究数据库（NHIRD）的数据进行了一项全国性回顾性队列研究。在整个随访期间，使用Cox比例风险模型比较了1岁前暴露于全身麻醉和未暴露于全身麻醉的儿童发生过敏性疾病的后续风险，这些过敏性疾病包括哮喘（ICD-9：493.X）、过敏性鼻炎（AR；ICD-9 CM编码477.X）和特应性皮炎（AD；ICD-9-CM编码691.X）。
NHIRD中所有参保儿童中32742名1岁以下儿童的保险理赔数据。其中，2358名受试者接受了全身麻醉；分别有414名和1944名接受面罩通气和插管通气的儿童作为研究队列，其余30384名儿童组成对照队列。全身麻醉组儿童患哮喘、AR和AD的风险较低，调整后的风险比分别为0.67（0.62 - 0.72，95%CI）、0.72（0.68 - 0.77，95%CI）、0.60（0.56 - 0.64，95%CI）。
与普通人群相比，1岁前在生命早期接受全身麻醉的儿童随后发生哮喘、AD和AR等过敏性疾病的风险降低。
