腺扁桃体手术指南对意大利耳鼻喉科医生临床行为的影响。

Q2 Medicine
Giovanni Motta, Sergio Motta, Pasquale Cassano, Salvatore Conticello, Massimo Ferretti, Bruno Galletti, Aldo Garozzo, Gennaro Larotonda, Nicola Mansi, Emilio Mevio, Gaetano Motta, Giuseppe Quaremba, Agostino Serra, Vincenzo Tarantino, Paolo Tavormina, Claudio Vicini, Maurizio Giovanni Vigili, Domenico Testa
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引用次数: 20

摘要

背景:近年来已经提出了一些关于腺扁桃体疾病的指南,并且出现了一些与临床表现和手术治疗指征相关的差异。该研究的目的是验证(腺)扁桃体切除术指南对意大利耳鼻喉科专家临床行为的影响。我们的研究是回顾性和多中心的病例系列与图表回顾。方法:该调查涉及14,770名儿童,年龄在2至11岁之间,2002年至2008年期间在14个意大利三级和二级转诊中心接受了腺扁桃体手术。采用方差分析进行统计分析,以p < 0.05为最小统计显著性值。结果:在研究期间和意大利政策文件发布后,腺扁桃体手术频率无显著变化(p>0.05)。总体而言,腺扁桃体切除术是最常见的干预措施(64.1%),其次是腺样体切除术(31.1%)和扁桃体切除术(4.8%)。除急性复发性扁桃体炎发热≥5次且无鼻塞时行腺扁桃体切除术(p = 0.010),即使去年急性复发性扁桃体炎发热< 5次时,各手术的手术指征均无显著变化(p>0.05)。在65.2%的手术病例中,鼻阻塞与急性复发性扁桃体炎引起的发热发作相关,而43.3%的患者诊断为中耳炎。结论:意大利在2003年的一份政策文件中首先提出了这些建议,然后在2008年的指导方针中重新提出,但参与调查的耳鼻喉科单位并未实施这些建议。该研究强调了腺扁桃体手术的适应症是基于整体临床表现(合并症)而不是单一症状。根据通过随机对照试验获得的结果和从观察性研究中收集的数据,有必要制定指南以提供连贯的建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy.

Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy.

Unlabelled:

Background: Several guidelines on adeno-tonsillar disease have been proposed in recent years and some discrepancies in relation both to clinical manifestations and indications for surgical treatment have emerged. The aim of the study was to verify what influence (adeno)-tonsillectomy guidelines have had on the clinical behaviour of ENT specialists in Italy. Our study is a retrospective and multi-centre case series with chart review.

Methods: The survey involved 14,770 children, aged between the ages of 2 and 11, who had undergone adeno-tonsillar surgery between 2002 and 2008 in fourteen Italian tertiary and secondary referral centres. Anova test was used for the statistical analysis, assuming p < 0.05 as the minimum statistical significance value.

Results: The frequency of adeno-tonsillar surgeries did not change significantly (p>0.05) during the study period and following the Italian policy document publication. Overall, adeno-tonsillectomy was the most frequent intervention (64.1%), followed by adenoidectomy (31.1%) and tonsillectomy (4.8%). The indications for surgery did not change significantly for each of the operations (p>0.05), with the exception of adeno-tonsillectomy in case of feverish episodes due to acute recurrent tonsillitis ≥ 5 without nasal obstruction (decreased p= 0.010) , even when the feverish episodes due to acute recurrent tonsillitis were < 5 over the last year. Nasal obstruction was associated with feverish episodes due to acute recurrent tonsillitis in 65.2% of operated cases, while otitis media had been diagnosed in 43.3% of the patients studied.

Conclusions: The recommendations first developed in Italy in a 2003 policy document and then resumed in guidelines in 2008, were not implemented by ENT units involved in the survey. The study highlights the fact that the indications for adeno-tonsillar operations are based on the overall clinical presentation (comorbidity) rather than on a single symptom. Guidelines are necessary to give coherent recommendations based on both the findings obtained through randomized controlled trials and the data collected from observational studies.

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来源期刊
BMC Ear, Nose and Throat Disorders
BMC Ear, Nose and Throat Disorders Medicine-Otorhinolaryngology
CiteScore
3.30
自引率
0.00%
发文量
0
期刊介绍: BMC Ear, Nose and Throat Disorders is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of ear, nose and throat disorders, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Ear, Nose and Throat Disorders (ISSN 1472-6815) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.
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