扁桃体切除术后舌扁桃体增生的临床观察

Clinical observation of lingual tonsil hyperplasia after tonsillectomy

目的观察扁桃体切除术后对于咽淋巴内环,主要是舌扁桃体代偿性增生的情况。方法对40例双侧扁桃体切除后的患者进行回顾性统计分析。分别对观察组及对照组进行喉镜检查记录舌扁桃体增生情况,同时对观察组及对照组进行咽喉症状量表(C-LSQ),并进行统计分析。结果观察组术后LTH分级情况:0级0例,1级11例,2级12例,3级10例,4级7例,其中舌扁桃体明显增生者(LTH分级升高2级或以上)13例。与观察组术前和对照组相比,术后患者舌扁桃体明显增生。两组患者行咽部症状量表分析示术后咽部不适评分为2.45±1.28,较术前评分(1.06±0.75)及对照组(0.96±0.85)显著升高;反复清嗓评分(1.48±1.25)亦较对照组(0.59±0.96)明显提高;咽异物感评分为(2.98±1.64)较术前评分(0.98±1.06)及对照组(0.64±0.83)均有显著提高。结论对于咽淋巴内环中扁桃体切除后,舌扁桃体存在代偿性增生,且部分会引起相应的咽喉部不适。

OBJECTIVE To obse r ve the compensatory hyperplasia of lingual tonsils in the Waldeyer ring after tonsillectomy. METHODS A retrospective statistical analysis was performed on 40 patients after bilateral tonsillectomy. The hyperplasia of tongue tonsil judged by laryngoscope was recorded in the observation group and the control group, and the laryngeal sensation questionnaire(C-LSQ) was performed in the observation group and the control group. RESULTS The postoperative lingual tonsil hyperplasia(LTH) grading in the observation group were 0 case with grade 0, 11 cases with grade 1, 12 cases with grade 2, 10 cases with grade 3, 7 cases with grade 4, 13 cases with obvious LTH(LTH grade increased by grade 2 or above). Compared with the control group and preoperative group, the LTH was obvious. The results of the laryngeal sensation questionnaire showed that the score of abnormal sensation of the throat in patients after tonsillectomy(2.45±1.28) was significantly higher than that in preoperative(1.06±0.75) and control group(0.96±0.85). Clearing throat score(1.48±1.25) was also significantly increased than the control group(0.59±0.96). The score of abnormal sensation in the throat(2.98±1.64) was significantly higher than that before tonsillectomy(0.98±1.06) and control group(0.64±0.83). CONCLUSION There is compensatory hyperplasia of lingual tonsils after tonsillectomy in the Waldeyer ring,and some of them may cause discomfort in the throat.