Detection of Respiratory Pathogens Does Not Predict Risks After Outpatient Adenotonsillectomy.
Detection of Respiratory Pathogens Does Not Predict Risks After Outpatient Adenotonsillectomy.
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呼吸道病原体的检测并不能预测门诊腺样体扁桃体切除术后的风险。
DOI：
10.1002/lary.29236
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Strub GM
中科院分区：
文献类型：
--
作者：
Vickers DM;Reddy A;Akmyradov C;Brown KM;Boyanton BL Jr;Wright HD;Taylor JA;Childress SH;Hartzell LD;Johnson AB;Key JM;Nolder AR;Richter GT;Wineland AM;Strub GM
确定在腺样体切除术/腺扁桃体切除术时可检测到的上呼吸道感染（uri）的存在是否与发病率、并发症和意外入院增加有关。前瞻性双盲队列。在这项前瞻性队列研究中，164名接受门诊腺样体切除术/扁桃体切除术的儿童患者术中获得鼻咽拭子，有或没有压力均衡管（pet），并使用PCR分析22种已知uri的存在，包括SARS‐CoV‐2。外科医生和家属对结果一无所知。在研究结束时，确定了可检测到的感染率，并比较了感染和未感染患者的术中和术后事件（意外入院、PACU住院时间、喉痉挛/支气管痉挛发生率、氧饱和度降低、心动过缓和术后急诊就诊）。164例患者（男性50%，女性50%，年龄8月- 18岁）中，136例患者（82.9%）在手术时检测出一种或多种URI阳性。41名患者（25.0%）同时有3个或更多的尿路感染呈阳性，11名患者（6.7%）同时有5个或更多的尿路感染呈阳性。在入院率、PACU停留时间、喉痉挛/支气管痉挛、氧饱和度降低、心动过缓或术后急诊科就诊方面，阳性和阴性患者无显著差异。没有患者检测出SARS - CoV - 2阳性。在门诊进行腺样体/扁桃体切除术的健康患者中，近期URI检测阳性并不会增加术中或术后风险。术前URI检测没有任何作用，并且由于近期URI检测呈阳性而延迟手术在这一人群中是不合理的。[3]喉镜，31:E2074-E2079, 2021
To determine whether the presence of detectable upper respiratory infections (URIs) at the time of adenoidectomy/adenotonsillectomy is associated with increased morbidity, complications, and unexpected admissions. Prospective double‐blinded cohort. In this prospective cohort study, nasopharyngeal swabs were obtained intraoperatively from 164 pediatric patients undergoing outpatient adenoidectomy/tonsillectomy with or without pressure equalization tubes (PETs) and were analyzed with PCR for the presence of 22 known URIs, including SARS‐CoV‐2. Surgeons and families were blinded to the results. At the conclusion of the study, rates of detectable infection were determined and intraoperative and postoperative events (unexpected admissions, length of PACU stay, rates of laryngospasm/bronchospasm, oxygen desaturation, bradycardia, and postoperative presentation to an emergency department) were compared between infected and uninfected patients. Of the 164 patients (50% male, 50% female, ages 8 mo‐18 y), 136 patients (82.9%) tested positive for one or more URI at the time of surgery. Forty one patients (25.0%) tested positive for three or more URIs concurrently, and 11 (6.7%) tested positive for five or more URIs concurrently. There were no significant differences in admission rates, length of PACU stay, rates of laryngospasm/bronchospasm, oxygen desaturation, bradycardia, or postoperative presentation to an emergency department between positive and negative patients. No patients tested positive for SARS‐CoV‐2. A recent positive URI test does not confer any additional intraoperative or postoperative risk in the setting of outpatient adenoidectomy/tonsillectomy in healthy patients. There is no utility in preoperative URI testing, and delaying surgery due to a recent positive URI test is not warranted in this population. 3 Laryngoscope, 131:E2074–E2079, 2021
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影响因子：
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