Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Arkansas Otolaryngology Centers, Little Rock, AR, USA.
Ear Nose Throat J. 2023 May;102(5):NP206-NP211. doi: 10.1177/01455613211000832. Epub 2021 Mar 18.
To analyze the impact of steroids on postoperative tonsillectomy recovery and implement findings for improvement in postoperative management.
Institutional review board approved prospective study with retrospective analysis of private practice setting tonsillectomy patients (November 2015 to January 2017). A questionnaire was provided postoperatively to patients undergoing tonsillectomy with or without adenoidectomy. The study population was separated into 2 groups: patients who received steroids (3 days of either dexamethasone or prednisolone), postoperative steroid (POS), versus patients who did not receive steroids (PONS).
The questionnaire had a return rate of 27.3% (254/931). Nine of the 254 responses were disqualified for lack of information; therefore, the total number of responses was 245. Of these, 115 were POS and 130 were PONS. The groups were similar in mean age (POS: 13.2 ± 10.4 years, PONS: 14.7 ± 12.1 years, = .32) and sex (POS: Male 40.0%, PONS: Male 40.0%, = .97). There was an overall decrease of pain and nausea/vomiting (N/V) in the steroid group ( = .0007). There was reduction in pain ( < .05) from postoperative day (POD) 2, 3, 4, and 6 in the POS group. Otherwise, there was no significant reduction in pain from POD 7 to 14, day-by-day rate of N/V, bleeding, or rate of emergency department (ED) or clinic visit ( > .05).
Postoperative steroid reduced overall pain and N/V, as well as daily pain on POD 2, 3, 4, and 6. Pain from POD 7 to 14, rate of ED or clinic visit, or daily N/V and bleeding rate were not significantly different between cohorts.
分析类固醇对扁桃体切除术后恢复的影响，并为改善术后管理提供依据。
本研究为机构审查委员会批准的前瞻性研究，对 2015 年 11 月至 2017 年 1 月在私人诊所行扁桃体切除术（伴或不伴腺样体切除术）患者进行回顾性分析。术后向患者发放调查问卷。研究人群分为两组：接受类固醇治疗（连续 3 天使用地塞米松或泼尼松）的患者（术后类固醇组，POS）和未接受类固醇治疗的患者（无术后类固醇组，PONS）。
问卷的回复率为 27.3%（254/931）。由于缺乏信息，254 份回复中有 9 份被排除在外，因此总回复数为 245 份。其中，POS 组 115 例，PONS 组 130 例。两组患者的平均年龄（POS 组：13.2 ± 10.4 岁，PONS 组：14.7 ± 12.1 岁， =.32）和性别（POS 组：男性 40.0%，PONS 组：男性 40.0%， =.97）相似。类固醇组的疼痛和恶心/呕吐（N/V）总体减轻（ =.0007）。POS 组术后第 2、3、4、6 天疼痛减轻（ <.05）。然而，从第 7 天到第 14 天，疼痛缓解并不明显，N/V 发生率、出血率或急诊就诊率（ >.05）。
术后类固醇可减轻总体疼痛和 N/V，以及术后第 2、3、4、6 天的每日疼痛。从第 7 天到第 14 天，ED 就诊率或门诊就诊率，或每日 N/V 和出血率在两组之间无显著差异。
