Effect of tonsillotomy on the inflammation and immune function in children with chronic tonsillitis
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摘要: 目的 探讨慢性扁桃体炎患儿行扁桃体部分切除术后炎症次数及免疫功能的变化，为临床治疗提供依据。方法 前瞻性收集2021年1—6月确诊为慢性扁桃体炎且合并腺样体、扁桃体肥大的儿童阻塞性睡眠呼吸暂停(OSA)患儿60例，分为两组，试验组(n=30)行低温等离子下双侧扁桃体部分切除术+腺样体切除术，对照组(n=30)行低温等离子下腺样体切除术。记录所有患儿术前、术后1年内的扁桃体炎发作次数，测定术前、术后1、3个月血清免疫球蛋白IgM、IgG、IgA、补体C3及补体C4数值。结果 试验组和对照组患儿术后1年的扁桃体炎发作次数均低于术前(P < 0.05)；试验组炎症发作次数[(0.50±0.63)次/年]较对照组[(1.33±0.80)次/年]更少。两组患儿术后1、3个月免疫五项结果与术前比较，差异无统计学意义，试验组和对照组间差异亦无统计学意义。结论 扁桃体部分切除术可应用于慢性扁桃体炎患儿，可有效减少扁桃体炎发作次数，对患儿免疫功能无影响。Abstract: Objective To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy.Methods Prospectively collected 60 children with obstructive sleep apnea (OSA) diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group (n=30) underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group (n=30) underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured.Results The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery(P < 0.05); The number of inflammatory attacks in the experimental group was (0.50±0.63) times/year, which was lower than that of (1.33±0.80) times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups.Conclusion Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children.
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Key words:
- tonsillitis /
- tonsillotomy /
- immune function
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表 1 试验组和对照组不同年龄段比较
例(%) 组别 例数 年龄段 2~4岁 >4~6岁 >6~8岁 >8岁 试验组 30 3(10.0) 11(36.7) 12(40.0) 4(13.3) 对照组 30 5(16.7) 10(33.3) 13(43.3) 2(6.7) 合计 60 8(13.3) 21(35.0) 25(41.7) 6(10.0) 
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表 2 试验组和对照组扁桃体炎发作次数比较
次/年 组别 术前 术后 术前术后差值 试验组 4.30±1.34 0.50±0.63 3.80±1.22 对照组 4.23±1.10 1.33±0.80 2.90±1.30 t值 0.21 -4.48 2.78 P值 >0.05 < 0.01 < 0.01
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表 3 试验组与对照组各自术前术后免疫指标比较
g/L， X±S 免疫指标 试验组 对照组 术前 术后1个月 术后3个月 术前 术后1个月 术后3个月 IgA 1.65±0.74 1.67±0.66 1.93±0.89 1.95±0.87 1.99±0.81 2.07±0.78 IgG 11.17±2.02 11.45±1.68 11.42±1.81 11.35±1.38 11.26±1.27 10.94±1.07 IgM 1.32±0.60 1.35±0.56 1.33±0.62 1.48±0.57 1.54±0.47 1.52±0.55 C4 0.22±0.10 0.23±0.08 0.23±0.08 0.22±0.06 0.23±0.05 0.23±0.05 C3 1.01±0.18 1.05±0.19 1.04±0.18 1.04±0.24 1.05±0.18 1.06±0.21
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表 4 试验组与对照组各项免疫指标对比
g/L， X±S 免疫指标 试验组 对照组 t值 P值 IgA 术前 1.65±0.74 1.95±0.87 -1.44 >0.05 术后1个月 1.67±0.66 1.99±0.81 -1.68 >0.05 术后3个月 1.93±0.89 2.07±0.78 -0.65 >0.05 IgG 术前 11.17±2.02 11.35±1.38 -0.41 >0.05 术后1个月 11.45±1.68 11.26±1.67 0.51 >0.05 术后3个月 11.42±1.81 10.94±1.07 1.24 >0.05 IgM 术前 1.32±0.60 1.48±0.57 -1.01 >0.05 术后1个月 1.35±0.56 1.54±0.47 -1.41 >0.05 术后3个月 1.33±0.62 1.52±0.55 -1.27 >0.05 C4 术前 0.22±0.10 0.22±0.06 0.01 >0.05 术后1个月 0.23±0.08 0.23±0.05 0.17 >0.05 术后3个月 0.23±0.08 0.23±0.05 -0.18 >0.05 C3 术前 1.01±0.18 1.04±0.24 -0.43 >0.05 术后1个月 1.05±0.19 1.05±0.18 0.12 >0.05 术后3个月 1.04±0.18 1.06±0.21 -0.48 >0.05
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