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囊内扁桃体次全切除术可能是儿童扁桃体切除术的首选。

Subtotal intracapsular tonsillectomy may be the first choice for tonsillectomy in children.

作者信息

Wang Jie, Dang Pan-Hong, Chang Huan-Huan, Wang Zi-Han

机构信息

Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710003, China.

出版信息

J Int Med Res. 2021 May;49(5):3000605211011930. doi: 10.1177/03000605211011930.

DOI:10.1177/03000605211011930
PMID:33947259
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8113930/
Abstract

OBJECTIVE

To investigate the effect and prognosis of subtotal intracapsular tonsillectomy.

METHODS

All children (n=162) with tonsillar hypertrophy and chronic tonsillitis were randomly divided into two groups: tonsillectomy (n=75) and subtotal intracapsular tonsillectomy (n=87). Tonsillectomy: the tonsillar tissue was completely removed along with the tonsillar capsule. Subtotal intracapsular tonsillectomy: 80% to 90% of the tonsils and the complete epithelium of the tonsillar crypts were removed without damaging the tonsillar capsule. The Face, Legs, Activity, Cry, and Consolability (FLACC) and parents' postoperative pain measure (PPPM) scales were used to evaluate postoperative pain, and the obstructive sleep apnea (OSA)-18 questionnaire was used to assess the children's postoperative quality of life. The patients were followed-up for 2 years.

RESULTS

  1. The FLACC and PPPM scales indicated that the children's postoperative pain after subtotal intracapsular tonsillectomy was significantly less than that of children undergoing tonsillectomy. 2. The OSA-18 scale scores indicated that subtotal intracapsular tonsillectomy significantly improved the children's quality of life. 3. Two years after subtotal intracapsular tonsillectomy, no patients required reoperation.

CONCLUSION

Subtotal intracapsular tonsillectomy may be the first choice for tonsillar hypertrophy and chronic tonsillitis patients.

摘要

目的

探讨囊内扁桃体次全切除术的效果及预后。

方法

将所有患有扁桃体肥大和慢性扁桃体炎的儿童（n = 162）随机分为两组：扁桃体切除术组（n = 75）和囊内扁桃体次全切除术组（n = 87）。扁桃体切除术：将扁桃体组织连同扁桃体包膜一并完全切除。囊内扁桃体次全切除术：切除80%至90%的扁桃体及扁桃体隐窝的完整上皮，不损伤扁桃体包膜。采用面部、腿部、活动、哭闹及安慰度（FLACC）量表和家长术后疼痛测量（PPPM）量表评估术后疼痛情况，采用阻塞性睡眠呼吸暂停（OSA）-18问卷评估患儿术后生活质量。对患者进行了2年的随访。

结果

  1. FLACC量表和PPPM量表显示，囊内扁桃体次全切除术后患儿的术后疼痛明显少于接受扁桃体切除术的患儿。2. OSA-18量表评分表明，囊内扁桃体次全切除术显著改善了患儿的生活质量。3. 囊内扁桃体次全切除术后两年，无患者需要再次手术。

结论

囊内扁桃体次全切除术可能是扁桃体肥大和慢性扁桃体炎患者的首选术式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/f9e5b84cddbd/10.1177_03000605211011930-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/dd05180e9bfb/10.1177_03000605211011930-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/d8b52aab8b3f/10.1177_03000605211011930-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/f9e5b84cddbd/10.1177_03000605211011930-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/dd05180e9bfb/10.1177_03000605211011930-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/d8b52aab8b3f/10.1177_03000605211011930-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a44/8113930/f9e5b84cddbd/10.1177_03000605211011930-fig3.jpg

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