扁桃体切除术对复发性扁桃体炎发病率的影响。
The effect of tonsillectomy on the morbidity from recurrent tonsillitis.
作者信息
Douglas C M, Lang K, Whitmer W M, Wilson J A, Mackenzie K
机构信息
Department of Otolaryngology - Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, UK.
MRC/CSO Institute of Hearing Research - Scottish Section, Glasgow Royal Infirmary, Glasgow, UK.
出版信息
Clin Otolaryngol. 2017 Dec;42(6):1206-1210. doi: 10.1111/coa.12850. Epub 2017 Mar 9.
BACKGROUND
Tonsillitis is a common condition with an incidence in UK general practice of 37 per 1000 population a year. Recurrent tonsillitis results in significant morbidity and impacts on individuals' quality of life. This study assesses the morbidity and quality of life of adults with recurrent tonsillitis, and the impact of surgical intervention on their health state.
OBJECTIVES
To describe disease-specific and global quality of life for adults with recurrent tonsillitis 6 months after tonsillectomy, using two instruments: the health impact of throat problems (HITP) and EuroQol-visual analogue scale questionnaire. To assess the overall health benefit from tonsillectomy as an intervention using the Glasgow Benefit Inventory (GBI). To assess potential predictors of tonsillectomy benefit.
DESIGN
A prospective, observational cohort audit of patients who have fulfilled Scottish Intercollegiate Guideline Network (SIGN) criteria for tonsillectomy. SETTING: Secondary care, teaching hospital.
PARTICIPANTS
Seventy patients (57 female), median age 20 years (range 13-41).
RESULTS
Median preoperative HITP was 47 (range 15-67), compared to 4 (0-72), (P<.001) 6 months following surgery. Median HITP difference was 39.5 (range -20 to 75). There was no significant change in global Quality of Life. Median overall 6 months GBI was 39 (-3 to 100). Patients had an average of 27 episodes of tonsillitis over a period of seven years before "achieving" tonsillectomy, significantly higher than the SIGN guidelines of three or more episodes over three years.
CONCLUSIONS
Recurrent tonsillitis causes a poor disease-specific quality of life. Patients experienced a median of three episodes per year for seven years before tonsillectomy. Following tonsillectomy, patients had a significant improvement in their disease-specific quality of life. Baseline HITP significantly improved after tonsillectomy. The results imply patients with recurrent acute tonsillitis may be experiencing undue delay.
背景
扁桃体炎是一种常见病症，在英国普通医疗实践中的发病率为每年每1000人中有37例。复发性扁桃体炎会导致严重发病，并影响个人生活质量。本研究评估复发性扁桃体炎成人患者的发病率和生活质量，以及手术干预对其健康状况的影响。
目的
使用两种工具，即咽喉问题健康影响量表（HITP）和欧洲生活质量视觉模拟量表问卷，描述扁桃体切除术后6个月复发性扁桃体炎成人患者的疾病特异性和总体生活质量。使用格拉斯哥效益量表（GBI）评估扁桃体切除术作为一种干预措施的总体健康效益。评估扁桃体切除术效益的潜在预测因素。
设计
对符合苏格兰校际指南网络（SIGN）扁桃体切除术标准的患者进行前瞻性观察队列审计。
地点
二级医疗，教学医院。
参与者
70名患者（57名女性），中位年龄20岁（范围13 - 41岁）。
结果
术前HITP中位数为47（范围15 - 67），术后6个月为4（0 - 72），（P <.001）。HITP中位数差异为39.5（范围 - 20至75）。总体生活质量无显著变化。6个月时GBI总体中位数为39（ - 3至100）。患者在“接受”扁桃体切除术之前的七年中平均有27次扁桃体炎发作，显著高于SIGN指南中三年三次或更多次发作的标准。
结论
复发性扁桃体炎导致较差的疾病特异性生活质量。患者在扁桃体切除术之前的七年中每年平均发作三次。扁桃体切除术后，患者的疾病特异性生活质量有显著改善。扁桃体切除术后基线HITP显著改善。结果表明复发性急性扁桃体炎患者可能存在过度延迟治疗的情况。
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