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对周期性发烧综合征进行桃体切除术:一个随机和受控试验
Ulla Lantto1,2, Terhi Tapiainen1,3, Tytti Pokka1
1Clinical Medicine Research Unit, Medical Research Center, University of Oulu, Oulu, Finland.
The Laryngoscope
|July 21, 2023
概括
与观察相比,桃切除术显著减少了患有周期性发烧,口腔口炎,喉炎和宫腺炎 (PFAPA) 综合征的儿童的症状. 这种程序为儿童患者的PFAPA管理提供了一个有希望的替代方案.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科免疫学 儿科免疫学
- 临床试验研究 临床试验研究
背景情况:
- 周期性发烧,口腔炎,喉炎和宫腺炎 (PFAPA) 综合征是儿童常见的自身炎症性疾病.
- 桃体切除术是一种成熟的治疗方法,但桃体切除术提供了一个侵入性较小的选择,具有潜在的更好的安全性.
- 桃体切除术与观察PFAPA综合征的比较疗效需要进一步研究.
研究的目的:
- 为了评估桃体切除术的疗效,与仅在被诊断为PFAPA综合征的儿童中进行观察相比.
- 在3个月的随访期内评估症状缓解和发烧负担.
- 为了确定后续桃体切除术在两个治疗手臂的需要.
主要方法:
- 进行了一项随机的多中心试验,采用了顺序设计.
- 16名患有PFAPA综合征的儿科患者被随机分配到桃体切除组或仅观察的对照组.
- 每天使用症状日记来监测疾病活动和治疗结果.
主要成果:
- 与观察组 (25%) (p=0.0021) 相比,桃体切除组中显著更高比例的患者 (87.5%) 实现了症状缓解.
- 与PFAPA综合征相容的发烧日数的平均数量在桃体切除组 (0.8天) 与对照组 (6.5天) (p=0.007) 相比,在桃体切除组 (0.8天) 中明显较低.
- 观察组的所有患者最终需要救援桃体切除术,而桃体切除组中没有人这样做.
结论:
- 桃体切除似乎是患有PFAPA综合征的儿童的有效治疗方法.
- 该程序显示,PFAPA症状和发烧发作显著减少.
- 需要进一步的研究来确定桃体切除术在治疗PFAPA综合征方面的长期有效性.
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