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资源有限环境下腺样体切除术的回顾与结果

A Review and Outcome of Adenoidectomy Performed in Resource Limited Settings.

作者信息

Gabriel Olajide Toye, Oyebanji Olajuyin

机构信息

Department of Ear, Nose and Throat Surgery, Federal Medical Centre, Ido Ekiti, Ekiti State Nigeria.

2Department of Ear, Nose and Throat Surgery, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State Nigeria.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):1-4. doi: 10.1007/s12070-014-0789-0. Epub 2014 Oct 31.

Abstract

Adenoidectomy remains invaluable in alleviating the obstructive symptoms of adenoid enlargement in children. The aim of this study is to review the conventional method of adenoidectomy with a view to establish its role and success in resource limited setting. A 5-year retrospective review of pediatric patients that had adenoidectomy operations done at two tertiary healthcare facilities was conducted. The clinic, ward, theatre registers and the patients' case files were the sources of information. Patients that had adenoidectomy with other otolaryngological procedures were excluded from the study. Data generated were descriptively analyzed using SPSS version 14.0. A total of 71 patients had adenoidectomy done. Of this, 65 cases were reviewed. There were a total of 45 males and 20 females with age range 11 months-10 years. The main indication for surgery was obstructive nasal symptoms. Conventional adenoidectomy was performed with standard adenoid curette. Intra-operative blood loss was less than 60 ml and none of the patients had blood transfusion. The average duration of admission post-operatively was 1.1 day. Fifty-eight (89 %) of the patients were relieved of their obstructive symptoms postoperatively. Conventional curettage adenoidectomy still have a role to play especially in resource limited setting where newer techniques may be nothing but a luxury. Adequate preoperative work-up, good anesthetic and surgical techniques are sine-qua-none to successful surgical outcome. There is also a need for early referral to otolaryngologists as this will not only ensure optimal intervention but also minimal postoperative complications.

摘要

腺样体切除术在缓解儿童腺样体肥大的阻塞性症状方面仍然具有重要价值。本研究的目的是回顾腺样体切除术的传统方法,以确定其在资源有限环境中的作用和成功率。对在两家三级医疗机构接受腺样体切除手术的儿科患者进行了为期5年的回顾性研究。诊所、病房、手术室登记册和患者病历是信息来源。将接受腺样体切除术并同时进行其他耳鼻喉科手术的患者排除在研究之外。使用SPSS 14.0软件对生成的数据进行描述性分析。共有71例患者接受了腺样体切除术。其中,65例接受了回顾。共有45名男性和20名女性,年龄范围为11个月至10岁。手术的主要指征是阻塞性鼻症状。采用标准腺样体刮匙进行传统腺样体切除术。术中失血量少于60毫升,所有患者均未输血。术后平均住院时间为1.1天。58例(89%)患者术后阻塞性症状得到缓解。传统的刮匙腺样体切除术仍然具有重要作用,尤其是在资源有限的环境中,新技术可能只是一种奢侈。充分的术前检查、良好的麻醉和手术技术是手术成功的必要条件。此外,需要尽早转诊至耳鼻喉科医生,因为这不仅能确保最佳干预,还能将术后并发症降至最低。

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