摘要
目的：通过随访观察扁桃体切除术对慢性扁桃体炎合并原发性系膜增生性肾小球肾炎的疗效。方法回顾某三级甲等医院2009年1月—2011年12月有完整资料的原发性系膜增生性肾小球肾炎住院病例67例,肾炎患者均合并慢性扁桃体炎。根据是否同意切除扁桃体将其随机分为手术组49例和非手术组18例,两组在随访过程中均接受了肾炎的常规治疗。观察两组治疗前后的一般情况、前驱症状、病程、临床表现,通过比较分析两组间及手术后各时期（治疗前、治疗后0.5个月、1个月、6个月、1年、3年）的24 h尿蛋白定量及1 h尿红细胞计数水平的变化。采用SPSS 15.0软件包进行统计学分析。结果两组患者治疗前、治疗后0.5个月24 h尿蛋白水平及1 h尿红细胞计数水平比较差异均无统计学意义（P〉0.05）；手术组治疗后1个月、6个月、1年、3年24 h尿蛋白水平分别为（0.89±0.38）,（0.59±0.23）,（0.41±0.15）,（0.38±0.17）g,均低于非手术组,差异有统计学意义（t值分别为5.711,8.563,10.282,10.488；P〈0.001）；两组患者治疗后1个月、6个月、1年、3年1h尿红细胞计数水平比较差异均有统计学意义（P〈0.001）,手术组优于非手术组。两组总疗效：术后6个月手术组有效率高于非手术组,差异有统计学意义（Z=2.316,P=0.024）；远期随访结果：手术组满1年时进一步好转率优于对照组差异有统计学意义（Z=3.364,P=0.009）；满3年时手术组进展率低于非手术组,差异有统计学意义（Z=5.832,P=0.002）。结论3年的随访结果证实扁桃体切除术能够延缓肾炎病情的进展,可能对肾脏的长期预后及肾脏生存情况有益,但需要考虑其禁忌证和适应证,在全身情况稳定的病程早期切除扁桃体。
Objective To observe the curative effect of chronic tonsillitis with primary mesangial proliferative glomerulonephritis after tonsillectomy by follow-up. Methods We retrospect to analyze 67 patients with definite diagnosis of mesangial proliferative glomerulonephritis and complete data in hospital during January 2009 to December 2011. According to whether they allowed to have tonsillectomy, we divided them into experimental group （ 49 cases, accepted tonsillectomy ） and control group （ 18 cases, do not accepted tonsillectomy） . All patients in two groups underwent routine care of nephritis during follow-up. We compared and analyzed the general information, precursory symptom, the process of disease, clinical symptom, and 24 h urine protein amount and 1 h urine red cell count before treatment and 0. 5 month, 1 month, 6 month, 1 year and 3 years after treatment between two groups. The software of SPSS15. 0 had been used for statistical analysis. Results The amount of 24 h urine protein and 1 h urine red cell had no statistical significance before treatment, 0. 5 month after treatment between two groups （P〉0. 05）;24 h urine protein amounts were （0. 89 ± 0. 38）, （0. 59 ± 0. 23）, （0. 41 ± 0. 15）, （0. 38 ± 0. 17） g at 1 month, 6 months, 1 year, 3 years after treatment lower than those of the control group （t=5. 711,8. 563,10. 282,10. 488,respectively; P〈0. 001）; the amounts of urine red cell were statistically significant at 1 month, 6 months, 1 year, 3 years after treatment between two groups （P〈0. 001）. The total curative effect in the experiment group was higher than that of the control group （Z=2. 316,P=0. 024）;the further improvement rate of experimental group was better than that of the control group after 1 year′s treatment, but it represented an opposite trend between two group after 3 years′ treatment（Z=5. 832,P=0. 002）. Conclusions The three-year follow-up results confirms that tonsillectomy could delay the process of glomerulonephritis and might benef
出处
《中华现代护理杂志》
2015年第12期1372-1375,共4页
Chinese Journal of Modern Nursing
关键词
肾小球肾炎
膜增生性
扁桃体切除术
随访研究
Glomerulonephritis,mesangial proliferation
Tonsillectomy
Follow-up study
