腺样体、扁桃体切除术治疗儿童慢性鼻窦炎临床回顾性分析

Clinical retrospective analysis of treating children chronicRhino-sinusitis by using adenoidectomy or tonsillectomy

目的回顾性分析腺样体、扁桃体切除术对儿童慢性鼻窦炎(Chronic Rhinosinusitis,CRS)的临床疗效、并发症与免疫功能的影响。方法对117例儿童CRS腺样体、扁桃体切除术后临床疗效、免疫功能与并发症的临床资料进行回顾性分析。结果临床疗效:6个月随访,临床疗效治愈83例(70.94%),好转23例(19.66%),无效11例(9.4%),总有效率为90.6%;术后伴有并发症17例:出血6例(35.29%),扁桃体、腺样体组织残留3例(17.65%),术后感染4例(23.53%),其他损伤(复发、牙齿脱落或松动、口唇、舌损伤4例(23.53%);术后1、3、6月与术前,及术后1、3、6月间血清免疫球蛋白Ig A、Ig G、Ig M的含量相比差异无统计学意义(P>0.05)。结论腺样体扁桃体切除术治疗儿童CRS疗效确切,对机体体液免疫无明显影响,术后出血是其最常见的并发症,应引起重视。

Objective To evaluate the clinical efficacy of adenoidectomy or tonsillectomy in treating childrenchronicRhino- sinusitis（ CRS）, the complications and effect on immune function. Methods Retrospectively analyze the datas of clinical efficacy,occurrence of complications and immunefunction after adenoidectomy or tonsillectomyin 117 children suffered from CRS. Results After follow up for 6 months,83 cases were healed（ 70. 94%）,23 cases were effective（ 19. 66%）,11 cases were ineffective（ 9. 4%）,and the total effective rate was 90. 6%. Postoperative complications were occurred in 17 cases（ including 6 cases of primary of secondary bleeding,3 cases were tonsil or adenoids residual,4cases withother injury,4cases were postoperative infection）. Immunoglobulin were not obviously changed after adenoidectomy or tonsillectomy（ P 0. 05）.Conclusions Adenoidectomy or tonsillectomy is an effective surgical treatment for pediatric CRS,and has no significant effect on humoral immunity. More attention should be paidto the postoperative bleeding which is the most serious complications.