Wang Zhe, Zheng Chenhai, Hao Yibo, Duan Yanru, Cao Xiangrong, Zhang Zhiming, Qin Jie, Wu Dahai
Department of Otolaryngology, General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, Shenyang, 110016, Liaoning, China.
Postgraduate Training Base of China Medical University in the General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Eur Arch Otorhinolaryngol. 2025 Jun;282(6):2843-2854. doi: 10.1007/s00405-025-09221-2. Epub 2025 Jan 25.
To evaluate the efficacy of tonsillectomy and/or adenoidectomy for the treatment of nocturnal enuresis (NE) in children with obstructive sleep apnea (OSA).
PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to December 2023. We included all studies of children with OSA and NE who underwent adenoidectomy and/or tonsillectomy. Risk of bias assessment and meta-analyses of included studies were performed. The sources of heterogeneity were explored through subgroup analyses.
The combined overall remission (OR), complete remission (CR), and partial remission (PR) were 67%, 57%, and 4%, respectively, in NE children who underwent adenoidectomy and/or tonsillectomy. Therein, the pooled OR and CR of primary nocturnal enuresis in children with OSA were 67% and 59%, respectively. The pooled OR and CR of children who were treated with adenotonsillectomy (T&A) were 72% and 65%, respectively. The pooled OR and CR of children with OSA aged > 5 years were 67% and 58%, respectively. The pooled OR and CR of postoperative follow-up of ≤ 3 months were 64% and 52%, respectively. The pooled OR and CR of NE based on RCT studies were 37.3%.
The remission rate of NE children who underwent adenoidectomy and/or tonsillectomy was more than half. While the remission rate was significantly lower when RCT studies were included. This suggested that the actual NE remission rate may be lower than expected. Further studies with large sample sizes and control groups are expected to confirm the position of adenoidectomy and/or tonsillectomy in NE treatment.
评估扁桃体切除术和/或腺样体切除术治疗阻塞性睡眠呼吸暂停（OSA）儿童夜间遗尿（NE）的疗效。
检索了从创刊至2023年12月的PubMed、Embase、Cochrane图书馆和Web of Science。我们纳入了所有接受腺样体切除术和/或扁桃体切除术的OSA合并NE儿童的研究。对纳入研究进行偏倚风险评估和荟萃分析。通过亚组分析探讨异质性来源。
接受腺样体切除术和/或扁桃体切除术的NE儿童中，综合总体缓解率（OR）、完全缓解率（CR）和部分缓解率（PR）分别为67%、57%和4%。其中，OSA儿童原发性夜间遗尿的合并OR和CR分别为67%和59%。接受腺扁桃体切除术（T&A）的儿童的合并OR和CR分别为72%和65%。年龄>5岁的OSA儿童的合并OR和CR分别为67%和58%。术后随访≤3个月的合并OR和CR分别为64%和52%。基于随机对照试验（RCT）研究的NE合并OR和CR为37.3%。
接受腺样体切除术和/或扁桃体切除术的NE儿童缓解率超过一半。而纳入RCT研究时缓解率显著较低。这表明实际的NE缓解率可能低于预期。期待有大样本量和对照组的进一步研究来确定腺样体切除术和/或扁桃体切除术在NE治疗中的地位。
