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喉咽反流在小儿扁桃体切除术后并发症中的作用

Role of Laryngopharyngeal Reflux in Complications of Tonsillectomy in Pediatric Patients.

作者信息

Salturk Ziya, Kumral Tolgar Lutfi, Arslanoglu Ahmet, Aydogdu Imran, Yildirim Guven, Berkiten Guler, Uyar Yavuz

机构信息

Okmeydanı Eğitim ve Araştırma Hastanesi KBB Kliniği Darulaceze cad. Şişli/İstanbul, Istanbul, Turkey.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Sep;69(3):392-396. doi: 10.1007/s12070-015-0841-8. Epub 2015 Feb 11.

Abstract

Tonsillectomy and tonsillectomy with adenoidectomy are among the most common surgical procedures in otolaryngology practice. Gastroesophageal reflux was identified as a risk factor for complications in tonsillectomy. This prospective study was designed to assess the role of reflux in the development of complications following tonsillectomy in pediatric patients. Children (n = 60) who underwent tonsillectomy with adenoidectomy were divided into two groups, i.e., the laryngopharyngeal reflux (LPR) group and control group. Patients with LPR were identified by reflux symptom index and reflux finding score. Pain, hemorrhage, fever, nausea, vomiting, fever, dehydration, infection, and pulmonary problems were evaluated post operatively. The mean lengths of hospital stay were 2.11 days in the reflux group and 1.05 days in the control group. The difference was statistically significant. Visual analogue scores of both groups were similar on day 1 but it was significantly higher on day 7 and 14 in LPR group. Nausea and vomiting rates were 11.1 and 9.5 % for the patients in the LPR group and the controls, respectively. The difference between the two groups was not significant. The mean fever was 37.6 °C in the reflux group and 37.3 °C in the controls, which were not significantly different. 19 % of the controls and 22 % of the LPR group patients were readmitted. This difference was not statistically significant. There were two cases of bleeding in the reflux group, while no bleeding occurred in the control group. This difference was significant statistically. LPR is a risk factor for complications following tonsillectomy.

摘要

扁桃体切除术以及扁桃体切除术加腺样体切除术是耳鼻喉科临床实践中最常见的外科手术之一。胃食管反流被认为是扁桃体切除术中并发症的一个危险因素。这项前瞻性研究旨在评估反流在小儿扁桃体切除术后并发症发生过程中的作用。接受扁桃体切除术加腺样体切除术的儿童(n = 60)被分为两组,即喉咽反流(LPR)组和对照组。通过反流症状指数和反流发现评分来确定LPR患者。术后对疼痛、出血、发热、恶心、呕吐、发热、脱水、感染及肺部问题进行评估。反流组的平均住院天数为2.11天,对照组为1.05天。差异具有统计学意义。两组的视觉模拟评分在第1天相似,但LPR组在第7天和第14天显著更高。LPR组和对照组患者的恶心和呕吐发生率分别为11.1%和9.5%。两组之间的差异不显著。反流组的平均发热温度为37.6℃,对照组为37.3℃,差异不显著。对照组19%的患者和LPR组22%的患者再次入院。这一差异无统计学意义。反流组有2例出血,而对照组未发生出血。这一差异具有统计学意义。LPR是扁桃体切除术后并发症的一个危险因素。

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