类固醇与儿童扁桃体切除术后恢复的关联：一项回顾性研究。
The Association of Steroids and Pediatric Post-Tonsillectomy Recovery: A Retrospective Review.
文献信息
| PMID | 42807330 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sathvik Suryadevara |
| 作者单位 | Department of Otolaryngology, Head & Neck Surgery Saint Louis University School of Medicine St. Louis Missouri USA. |
| 期刊 | Laryngoscope investigative otolaryngology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 疼痛、脱水和出血仍是儿童扁桃体切除术患者的重要问题。关于术后门诊类固醇处方实践对扁桃体切除术后儿童人群潜在影响的文献很少。我们旨在研究术后口服类固醇疗程与疼痛、出血和脱水的关联，同时控制感染性适应证，以指导医生对该人群进行适当管理。
方法： 单机构回顾性研究，纳入2019年至2021年接受扁桃体切除术的2-18岁儿童患者。一组接受4剂术后口服地塞米松疗程，另一组未接受。在2-6岁和7-18岁患者中，在控制感染性适应证和其他因素后，估计类固醇与因出血、脱水或未控制疼痛相关急诊科就诊的关联。
结果： 共纳入2054例儿童扁桃体切除术患者。大多数为男性（50.8%）和非西班牙裔白人（63.7%），平均年龄为7.0岁（SD=3.9）。约三分之一（30.4%）患者接受了地塞米松，而地塞米松与出血、脱水或未控制疼痛/止痛药续方的显著更低几率无关。
结论： 在控制感染性适应证后，4剂术后地塞米松疗程与扁桃体切除术后出血、脱水或疼痛的显著减少无关。然而，作为辅助治疗可能是合理的。
证据等级： 3。
英文摘要
OBJECTIVES: Pain, dehydration, and bleeding remain significant concerns for pediatric tonsillectomy patients. The literature is sparse on potential effects of postoperative, outpatient steroid prescribing practices among the post-tonsillectomy pediatric population. We aim to investigate the association of a postoperative oral steroid course with pain, bleeding, and dehydration while controlling for infectious indication to guide physicians for appropriate management of this population.
METHODS: Single institution, retrospective review of pediatric patients aged 2-18 years who underwent tonsillectomy from 2019 to 2021. One group received a 4-dose course of postoperative oral dexamethasone, and the other did not. Among patients ages 2-6 and 7-18, the association of steroids with emergency department visits related to bleeding, dehydration, or uncontrolled pain was estimated while controlling for infectious indication and other factors.
RESULTS: There were 2054 pediatric tonsillectomy patients included. The majority were male (50.8%) and Non-Hispanic White (63.7%) with an average age of 7.0 years (SD = 3.9). About one-third (30.4%) of patients received dexamethasone, and dexamethasone was not associated with significantly lower odds of bleeding, dehydration, or uncontrolled pain/pain medication refills.
CONCLUSION: A 4-dose course of postoperative dexamethasone was not associated with a significant reduction in post-tonsillectomy bleeding, dehydration, or pain when controlling for infectious indication. However, it may be reasonable as an adjunct therapy.
LEVEL OF EVIDENCE: 3.