腺样体切除术翻修的发生率及相关因素：一项回顾性研究。
Incidence and factors associated with revision adenoidectomy: A retrospective study.
作者信息
Johnston James, Mahadevan Murali, Douglas Richard G
机构信息
University of Auckland, Department of Surgery, PO Box 99743, Newmarket, Auckland 1149, New Zealand.
Starship Children's Hospital, Private Bag 92024, Auckland 1142, New Zealand.
出版信息
Int J Pediatr Otorhinolaryngol. 2017 Dec;103:125-128. doi: 10.1016/j.ijporl.2017.10.023. Epub 2017 Oct 18.
INTRODUCTION
Adenoidectomy is one of the most commonly performed pediatric operations worldwide. There are a proportion of children who require revision adenoidectomy. Yet there is little in the literature about the incidence, associated factors and etiology of adenoidal regrowth. The aim of this retrospective cohort study was to determine incidence and factors associated with revision adenoidectomy.
METHODS
An extraction of all hospital morbidity records belonging to patients under the age of 18 years who underwent one or more adenoidectomy procedures (with or without tonsillectomy) between January 1, 2000 and June 2016 at a tertiary care children's hospital was performed. Demographic, diagnostic, and procedural data were included in the analysis. Community prescribing information was examined for the number of courses of antibiotics prescribed to each patient prior to initial adenoidectomy.
RESULTS
There were 8260 patients under the age of 18 years who underwent primary adenoidectomy from 2000 to 2016 at a tertiary pediatric hospital. 2.5% (n = 212) of patients underwent revision adenoidectomy in our cohort during the same time period. A higher proportion of females underwent revision adenoidectomy when compared to male counterparts (p = 0.007). Patients who were prescribed more than five courses of antibiotics prior to initial adenoidectomy were more likely to undergo revision adenoidectomy (p = 0.003). Patients with a diagnosis of otitis media with effusion were more likely to undergo revision adenoidectomy (p=<0.001). A diagnosis of asthma (p=<0.001), gastroesophageal reflux disease (GERD) (p=<0.001), and allergic rhinitis (p=<0.001) was associated with revision adenoidectomy. An age of over 4 years at the time of initial adenoidectomy was associated with revision adenoidectomy (p=<0.001). Adenoids that obstructed over 75% of the nasal choanae were associated with revision adenoidectomy in this cohort (p=<0.001).
CONCLUSION
This study has identified several factors associated with revision adenoidectomy.
引言
腺样体切除术是全球最常见的儿科手术之一。有一部分儿童需要进行腺样体切除修正手术。然而，关于腺样体再生的发生率、相关因素和病因，文献中报道较少。这项回顾性队列研究的目的是确定腺样体切除修正手术的发生率及相关因素。
方法
提取了2000年1月1日至2016年6月期间在一家三级儿童专科医院接受过一次或多次腺样体切除手术（无论是否同时进行扁桃体切除术）的18岁以下患者的所有医院发病记录。分析纳入了人口统计学、诊断和手术数据。检查了社区处方信息，以了解每位患者在初次腺样体切除术前开具的抗生素疗程数。
结果
2000年至2016年期间，一家三级儿科医院有8260名18岁以下患者接受了初次腺样体切除术。在同一时期，我们队列中有2.5%（n = 212）的患者接受了腺样体切除修正手术。与男性相比，接受腺样体切除修正手术的女性比例更高（p = 0.007）。初次腺样体切除术前开具超过五个疗程抗生素的患者更有可能接受腺样体切除修正手术（p = 0.003）。诊断为中耳积液的患者更有可能接受腺样体切除修正手术（p<0.001）。哮喘（p<0.001）、胃食管反流病（GERD）（p<0.001）和变应性鼻炎（p<0.001）的诊断与腺样体切除修正手术有关。初次腺样体切除术时年龄超过4岁与腺样体切除修正手术有关（p<0.001）。在该队列中，阻塞超过75%鼻后孔的腺样体与腺样体切除修正手术有关（p<0.001）。
结论
本研究确定了几个与腺样体切除修正手术相关的因素。
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