Article record

肥胖儿童扁桃体切除术后的呼吸系统并发症：系统评价与荟萃分析

Post-tonsillectomy Respiratory Complications in Children With Obesity: Systematic Review and Meta-analysis.

综述 Meta咽喉科IF 2.9Q1

文献信息

PMID	42808640
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Erin M Kirkham 查看其他 7 位作者 Nikhila Raol；Sharmi C Amin；Bo Hyun Kong；Aayush Sharma；Ahab Chopra；Mark P MacEachern；Prasanth Pattisapu
作者单位	Department of Otolaryngology: Head & Neck Surgery, The University of Michigan, Ann Arbor, Michigan, USA. 查看其他 8 条单位信息 Department of Otolaryngology, Baylor College of Medicine, Houston, Texas, USA.；Texas Children's Medical Center, Houston, Texas, USA.；University of Michigan Medical School, Ann Arbor, Michigan, USA.；Emory University School of Medicine, Atlanta, Georgia, USA.；The Ohio State University College of Medicine, Columbus, Ohio, USA.；Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA.；Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital and the Ohio State University Wexner Medical Center, Columbus, Ohio, USA.；Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.
期刊	Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
SCI 分区	Q1
IF	2.9
研究类型	综述 Meta · 临床
所属专科	咽喉科

中文摘要

目的： 量化并比较肥胖与非肥胖儿童在扁桃体切除术（伴或不伴腺样体切除术）后发生呼吸系统并发症的风险。
数据来源： Ovid MEDLINE、Embase、CINAHL 和 Clarivate Web of Science。
综述方法： 纳入报告18岁以下患者扁桃体切除术后呼吸系统并发症的研究。使用美国国家心肺血液研究所质量评估工具进行质量评估。采用随机效应模型计算比值比（OR）及95%置信区间（CI）的荟萃分析。亚组分析按事件护理阶段（仅住院 vs 麻醉后监护室[PACU]或住院）、扁桃体切除指征（任何 vs 仅睡眠呼吸障碍）和医疗复杂性（>20%有医疗合并症 vs ≤20%）划分研究。
结果： 共纳入18项研究，代表60,044例患者。手术时平均年龄范围为4.0至9.2岁，7.8%为肥胖（年龄和体重对应的体重指数>第95百分位）。并发症总体发生率为8.0%：肥胖儿童为12.2%，非肥胖儿童为7.6%。与非肥胖儿童相比，肥胖儿童发生并发症的比值显著增加（比值比[OR] 1.86 [95% CI 1.38-2.49，I2 = 77.5%]）。在排除PACU并发症的研究中，肥胖并未增加比值。
结论： 肥胖儿科患者扁桃体切除术后呼吸系统并发症的比值几乎是非肥胖儿童的两倍。然而，仅在包含PACU事件的研究中比值升高，而在仅限于住院病房的研究中并未升高。对于在PACU未出现并发症的肥胖儿童，出院可能是安全的。

英文摘要

OBJECTIVE: To quantify and compare the risk of respiratory complications between children with and without obesity after tonsillectomy (with or without adenoidectomy).
DATA SOURCES: Ovid MEDLINE, Embase, CINAHL, and Clarivate Web of Science.
REVIEW METHODS: Studies that reported post-tonsillectomy respiratory complications in patients <18 years old were included. Quality assessment was performed using National Heart, Lung, and Blood Institute quality assessment tools. Meta-analysis of odds ratios with 95% confidence interval (CI) was calculated using random-effects models. Subgroup analyses divided studies by phase of care of event (inpatient only vs post-anesthesia care unit [PACU] or inpatient), indication for tonsillectomy (any vs only sleep-disordered breathing), and medical complexity (>20% with medical comorbidity vs ≤20%).
RESULTS: In total, 18 studies representing 60,044 patients were included. The mean age at surgery ranged from 4.0 to 9.2 years, and 7.8% were obese (>95th body mass index percentile for age and weight). The overall frequency of complications was 8.0%: 12.2% in children with obesity and 7.6% in children without. Compared to children without, those with obesity had significantly increased odds of a complication (odds ratio [OR] 1.86 [95% CI 1.38-2.49, I2 = 77.5%]). Obesity did not increase the odds among studies that excluded PACU complications.
CONCLUSION: Pediatric patients with obesity have nearly twice the odds of post-tonsillectomy respiratory complications than those without. However, odds were elevated only in studies that included events in PACU but not in studies limited to the inpatient wards. Discharge may be safe for children with obesity who do not develop complications in PACU.