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小儿扁桃体切除术和等待手术的观察性实用生活质量研究。

An observational pragmatic quality-of-life study on paediatric tonsillectomy and waiting for surgery.

机构信息

Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia.

Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia.

出版信息

Eur Arch Otorhinolaryngol. 2023 Feb;280(2):885-890. doi: 10.1007/s00405-022-07659-2. Epub 2022 Sep 22.

Abstract

PURPOSE

To investigate parental perceptions of the effects of tonsillectomy on their child's quality of life while awaiting and following surgery in an Australian public health system.

METHODS

An observational pragmatic study was undertaken at a tertiary Australian hospital. Parents of paediatric patients (2-16 years of age) listed for tonsillectomy completed a validated quality-of-life questionnaire (T-14 Paediatric Throat Disorders Outcome Test) at the initial consultation, on day of surgery, 6 weeks post-operatively and 6 months post-operatively. T-14 scores were compared using the Related-Samples Wilcoxon Signed Rank Test.

RESULTS

Parents of 167 children participated in this study. There was a median wait time of 174 days (IQR 108-347) from the initial consultation until the day of surgery, with no significant change in median T-14 scores (35 [IQR 22-42] vs 36 [IQR 22-42]; n = 63; p > 0.05). There was a significant decrease from pre-operative T-14 scores to 6 weeks post-operatively (33.5 [IQR 22-42] vs 2 [IQR 0-5]; n = 160; p < 0.001), and this was sustained with a minor improvement at 6 months post-operatively (6 weeks 2 [IQR 0-5] vs 6 months 0 [IQR 0-2]; n = 148; p < 0.001).

CONCLUSIONS

Paediatric tonsillectomy improves quality of life with a sustained benefit in the long term. There is no improvement to the patient's quality of life while awaiting tonsillectomy, thus patient welfare can be improved through reducing waiting times for surgery.

摘要

目的

在澳大利亚公共卫生系统中,调查父母在等待和接受扁桃体切除术期间对孩子生活质量的影响。

方法

在一家澳大利亚的三级医院进行了一项观察性实用研究。接受扁桃体切除术的儿科患者(2-16 岁)的父母在初次就诊时、手术当天、术后 6 周和术后 6 个月时完成了一项经过验证的生活质量问卷(T-14 儿科喉咙疾病结局测试)。使用相关样本 Wilcoxon 符号秩检验比较 T-14 评分。

结果

本研究共纳入了 167 名儿童的父母。从初次就诊到手术日的平均等待时间为 174 天(IQR 108-347),T-14 评分中位数没有显著变化(35 [IQR 22-42] vs 36 [IQR 22-42];n=63;p>0.05)。与术前 T-14 评分相比,术后 6 周的评分显著降低(33.5 [IQR 22-42] vs 2 [IQR 0-5];n=160;p<0.001),术后 6 个月时评分略有改善(6 周 2 [IQR 0-5] vs 6 个月 0 [IQR 0-2];n=148;p<0.001)。

结论

小儿扁桃体切除术可提高生活质量,长期效果持续。在等待扁桃体切除术期间,患者的生活质量没有改善,因此减少手术等待时间可以提高患者的福利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9360/9849282/b4ca6e166e84/405_2022_7659_Fig1_HTML.jpg

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