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扁桃体切除术不能减少上呼吸道感染:一项全国队列研究。

Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study.

作者信息

Choi Hyo Geun, Park Bumjung, Sim Songyong, Ahn Soon-Hyun

机构信息

Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.

Department of Statistics, Hallym University, Chuncheon, Korea.

出版信息

PLoS One. 2016 Dec 30;11(12):e0169264. doi: 10.1371/journal.pone.0169264. eCollection 2016.

Abstract

OBJECTIVES

The objective of this study was to compare post-operative visits for upper respiratory infections (URIs) between tonsillectomy and non-tonsillectomy participants (controls).

METHODS

Using the national cohort study from the Korean Health Insurance Review and Assessment Service, 1:4 matched (age, sex, income, region, and pre-operative URI visit) tonsillectomy participants (5,831) and control participants (23,324) were selected. Post-operative visits for URI were measured from 1 to 9 years post-op. The equivalence test was used. The margin of equivalence of the difference (Tonsillectomy-Control group group) was set to -0.5 to 0.5.

RESULTS

There was no difference between the tonsillectomy and control group in 1- to 9-year post-op visits (-0.5 < 95% CI of difference < 0.5). URI visits gradually decreased from 5.5/2 years (pre-op) to 2.1/year (at 1 year post-op) and 1.4/year (at 9 years post-op) in both tonsillectomy and control groups. In the subgroup analysis (children Vs adolescent and adults; rare Vs frequent pre-operative URI), there was no difference in the number of post-op visits for URI between the tonsillectomy and control groups (-0.5 < 95% CI of difference < 0.5).

CONCLUSION

Tonsillectomy does not provide a decrease in the number of post-operative visits for URI, and URI decreased over time whether or not a tonsillectomy was performed.

摘要

目的

本研究的目的是比较扁桃体切除术参与者与非扁桃体切除术参与者(对照组)术后上呼吸道感染(URI)的就诊情况。

方法

利用韩国健康保险审查与评估服务机构的全国队列研究,选取了1:4匹配(年龄、性别、收入、地区和术前URI就诊情况)的扁桃体切除术参与者(5831例)和对照组参与者(23324例)。对术后1至9年的URI就诊情况进行测量。采用等效性检验。差异(扁桃体切除术组-对照组)的等效性界限设定为-0.5至0.5。

结果

扁桃体切除术组和对照组在术后1至9年的就诊情况无差异(差异的95%置信区间为-0.5 <差异< 0.5)。扁桃体切除术组和对照组的URI就诊次数均从术前的5.5次/2年逐渐降至术后1年的2.1次/年和术后9年的1.4次/年。在亚组分析(儿童与青少年及成人;术前URI罕见与频繁)中,扁桃体切除术组和对照组术后URI的就诊次数无差异(差异的95%置信区间为-0.5 <差异< 0.5)。

结论

扁桃体切除术并不能减少术后URI的就诊次数,无论是否进行扁桃体切除术,URI的次数都会随时间减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a78d/5201261/3eacdf79f9b9/pone.0169264.g001.jpg

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