Clinical Practice Guideline: Tonsillectomy in Children (Update)
Clinical Practice Guideline: Tonsillectomy in Children (Update)
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DOI：
10.1177/0194599818801757
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发表时间：
2019-02-01
影响因子：
3.4
通讯作者：
Nnacheta, Lorraine C.
中科院分区：
文献类型：
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作者：
Mitchell, Ron B.;Archer, Sanford M.;Nnacheta, Lorraine C.
目的：美国耳鼻喉头颈外科学会2011年制定的指南的更新，为考虑行扁桃体切除术的1 - 18岁儿童的术前、术中和术后护理和管理提供了循证建议。扁桃体切除术被定义为通过解剖扁桃体囊和肌壁之间的扁桃体周围空间，进行腺样体切除术或不进行腺样体切除术，完全切除扁桃体，包括其囊。扁桃体切除术是美国最常见的外科手术之一，每年在儿童中进行289,000例门诊手术目的本多学科指南的目的是确定在考虑扁桃体切除术的儿童中管理质量改进的机会，并创建明确和可操作的建议，以在临床实践中实施这些机会。具体来说，目标是教育临床医生、患者和/或护理人员扁桃体切除术的适应症和复发性喉咙感染的自然史。其他目标包括：优化接受扁桃体切除术的儿童的围手术期管理，强调对特殊人群的评估和干预的必要性，改善对考虑为其子女进行扁桃体切除术的家庭的咨询和教育，强调对有修饰因素的患者的管理选择，减少不适当或不必要的护理变化。1至18岁的儿童正在考虑扁桃体切除术是该指南的目标患者。为了更新指南，美国耳鼻喉头颈外科学会基金会选择了一个代表护理、麻醉学、消费者、家庭医学、传染病、耳鼻喉头颈外科、儿科和睡眠医学等领域的专家小组。关键行动声明指南更新小组对以下关键行动声明（KASs）提出了强烈建议：(1)临床医生应建议注意等待复发性喉咙感染，如果有的话
Objective This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children Purpose The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing children under consideration for tonsillectomy and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to educate clinicians, patients, and/or caregivers regarding the indications for tonsillectomy and the natural history of recurrent throat infections. Additional goals include the following: optimizing the perioperative management of children undergoing tonsillectomy, emphasizing the need for evaluation and intervention in special populations, improving the counseling and education of families who are considering tonsillectomy for their children, highlighting the management options for patients with modifying factors, and reducing inappropriate or unnecessary variations in care. Children aged 1 to 18 years under consideration for tonsillectomy are the target patient for the guideline. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of nursing, anesthesiology, consumers, family medicine, infectious disease, otolaryngology-head and neck surgery, pediatrics, and sleep medicine. Key Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should recommend watchful waiting for recurrent throat infection if there have been