Article record

COVID-19期间儿童分泌性中耳炎手术趋势：一项时间序列研究

Pediatric Otitis Media With Effusion Surgical Trends During COVID-19: A Time-Series Study.

临床研究耳科IF 2.3Q2

文献信息

PMID	42768420
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Hiroshi Hidaka 查看其他 17 位作者 Kunio Tarasawa；Kenji Fujimori；Tomoki Kitawaki；Kiyohide Fushimi；Ryoukichi Ikeda；Atsuko Nakano；Haruo Yoshida；Yosuke Kamide；Ken Hashimoto；Risako Kakuta；Kosuke Tochigi；Masashi Kasai；Haruo Kuroki；Yukiko Iino；Hitome Kobayashi；Arata Horii；Makoto Ito
作者单位	Department of Otorhinolaryngology-Head and Neck Surgery, Kansai Medical University, Hirakata, Japan. 查看其他 16 条单位信息 Department of Healthcare Administration and Policy, Tohoku University Graduate School of Medicine and Medical IT Center, Tohoku University Hospital, Sendai, Japan.；Tohoku University, Sendai, Japan.；Department of Mathematics, Kansai Medical University, Hirakata, Japan.；Department of Health Policy and Informatics, Institute of Science Tokyo Graduate School of Medical and Dental Sciences, Tokyo, Japan.；Department of Otolaryngology-Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.；Division of Otorhinolaryngology, Chiba Children's Hospital, Chiba, Japan.；Department of Otolaryngology-Head and Neck Surgery, National Hospital Organization Nagasaki Medical Center, Omura, Japan.；Kamide Ear Nose and Throat Clinic, Fuji, Japan.；Department of Otolaryngology, Jichi Medical University, Shimotsuke, Japan.；Department of Otolaryngology, Tohoku Rosai Hospital, Sendai, Japan.；Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.；Department of Infectious Diseases, Hyogo Prefectural Children's Hospital, Kobe, Japan.；Pauroom Clinic for Children and Parents, Tokyo, Japan.；Department of Otolaryngology, Tokyo-Kita Medical Center, Tokyo, Japan.；Showa Medical University Graduate School of Health Sciences, Yokohama, Japan.；Department of Otolaryngology-Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
期刊	The Laryngoscope
SCI 分区	Q2
IF	2.3
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

目的： 评估COVID-19大流行对日本儿童分泌性中耳炎（OME）手术的影响，比较一般人群与高危人群（唐氏综合征和腭裂），以区分手术需求的环境驱动因素和解剖驱动因素。
方法： 这项回顾性队列研究使用了日本诊断程序组合数据库（2013年4月至2023年3月）。纳入接受鼓膜置管或鼓膜切开术的18岁以下儿童。采用中断时间序列（ITS）分析来估计即时“水平变化”和大流行期间“趋势变化”，有效考虑10年预先存在的长期趋势，以分离大流行的影响。
结果： 在22,748例手术病例中，未观察到显著的大流行前趋势（+0.05例手术/月），随后出现显著的即时水平变化（-107.55例手术/月）和非显著的斜率变化（0.95例手术/月）。相比之下，唐氏综合征组和腭裂组的即时水平变化无统计学显著性，表明手术量相对保持。同期腺样体切除术和扁桃体切除术分别从38.8%显著下降至29.7%和从23.2%下降至16.9%（p < 0.001）。
结论： 虽然一般人群的OME手术量急剧下降，可能由于社区获得性呼吸道感染减少，但在高危儿童中仍保持韧性。这些发现表明，虽然环境因素驱动一般人群的OME，但解剖脆弱性使得高危群体即使在疫情期间也需要持续的手术干预。这种区分对未来公共卫生危机中的手术优先级提供了关键框架。

英文摘要

OBJECTIVE: To evaluate the impact of the COVID-19 pandemic on pediatric surgery for otitis media with effusion (OME) in Japan, comparing the general population with high-risk groups (Down syndrome and cleft palate) to differentiate between environmental and anatomical drivers of surgical demand.
METHODS: This retrospective cohort study used the Japanese Diagnosis Procedure Combination database (April 2013 to March 2023). Children < 18 years undergoing tympanostomy tube insertion or myringotomy were included. Interrupted time-series (ITS) analysis was employed to estimate immediate "level shifts" and pandemic-period "trend changes," effectively accounting for 10-year pre-existing secular trends to isolate the pandemic's impact.
RESULTS: Among 22,748 surgical cases, no significant pre-pandemic trend (+0.05 surgeries/month) was observed, followed by a significant immediate level shift (-107.55 surgeries/month) and a non-significant slope change (0.95 surgeries/month). In contrast, immediate level shifts in the Down syndrome and cleft palate groups were not statistically significant, indicating relatively preserved surgical volume. Concomitant adenoidectomy and tonsillectomy decreased significantly from 38.8% to 29.7% and 23.2% to 16.9%, respectively (p < 0.001).
CONCLUSIONS: While OME surgical volume for the general population plummeted, likely due to reduced community-acquired respiratory infections, it remained resilient in high-risk children. These findings suggest that while environmental factors drive OME in the general population, anatomical vulnerabilities necessitate consistent surgical intervention in high-risk groups even during a pandemic. This distinction provides a crucial framework for surgical prioritization in future public health crises.