儿童扁桃体部分切除术后并发症及再次手术率的观察  

Observation of postoperative complications and reoperation rate after partial tonsillectomy in children

作　　者：磨宾宇[1] 杨立[2] 田芳云 戴善军[1] 肖毅[1] 朱汉平[1] 李纪辉[1] MO Binyu;YANG Li;TIAN Fangyun;DAI Shanjun;XIAO Yi;ZHU Hanping;LI Jihui(Department of Otolaryngology,Liuzhou People’s Hospital,Guangxi,Liuzhou 545006,China;Department of Pathology,Liuzhou People’s Hospital,Guangxi,Liuzhou 545006,China)

机构地区：[1]广西壮族自治区柳州市人民医院耳鼻咽喉科,广西柳州545006 [2]广西壮族自治区柳州市人民医院病理科,广西柳州545006

出　　处：《中国医药科学》2025年第6期139-143,共5页China Medicine And Pharmacy

基　　金：广西壮族自治区卫生健康委员会项目课题(Z20200222);广西自然科学基金面上项目(2024GXNSFAA010079)。

摘　　要：目的 观察儿童扁桃体部分切除术后并发症的发生率及再次手术率。方法 将2013年1月至2023年12月因扁桃体肥大在柳州市人民医院接受手术,且完成随访的4275例儿童分为两组,扁桃体部分切除术(TT)组2567例,扁桃体完全切除术(TE)组1708例。收集住院天数、术后疼痛、发热及出血事件、术后感染、增生及再次手术患者的数据。结果 TT组的住院天数、术后疼痛程度、发热及出血事件发生的风险显著低于TE组(P <0.05)。初学者在TE组中术后出血事件发生率高于熟练者,但在TT组中差异无统计学意义(P> 0.05)。TT组再次手术仅1例(0.04%),术后标本切片显示隐窝形态正常,无瘢痕堵塞及炎症加重表现。结论 TT术后疼痛程度及不良反应事件的发生概率低于TE,出现反复感染、增生及再次手术的风险极低,而且对术者操作水平要求不高,可替代TE作为治疗儿童扁桃体肥大的首选方式。Objective To observe the incidence of postoperative complications and reoperation rate after partial tonsillectomy in children.Methods A total of 4275 children who underwent surgery for tonsillar hypertrophy at Liuzhou People’s Hospital from January 2013 to December 2023 and completed follow-up were divided into the partial tonsillectomy(TT)group(n=2567)and the complete tonsillectomy(TE)group(n=1708).Data on hospitalization days,postoperative pain,fever and hemorrhage events,postoperative infections,hyperplasia,and patients undergoing reoperation were collected.Results The hospitalization days,postoperative pain level,risk of fever and hemorrhage events in the TT group were significantly lower than those in the TE group,with statistically significant differences(P<0.05).The incidence of postoperative hemorrhage events was higher in beginners in the TE group than in proficient individuals,while there was no significant difference in the TT group(P>0.05).Only one case(0.04%)underwent reoperation in the TT group,and postoperative specimen slices showed normal crypt morphology without scar blockage or worsening inflammation.Conclusion The degree of pain and the probability of adverse reactions after TT surgery are lower than those of TE,and the risk of recurrent infection,hyperplasia,and reoperation is extremely low.Moreover,the operator’s operational level is not high,and it can be used as a substitute for TE as the preferred treatment for pediatric tonsillar hypertrophy.

关 键 词：扁桃体部分切除术 扁桃体全切术 儿童 扁桃体肥大 术后并发症 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]