{"id":13352,"date":"2023-10-17T10:22:59","date_gmt":"2023-10-17T10:22:59","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=13352"},"modified":"2023-10-17T10:23:03","modified_gmt":"2023-10-17T10:23:03","slug":"llr-policy-for-tonsillectomy-and-adenoidectomy","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/ro\/llr-policy-for-tonsillectomy-and-adenoidectomy\/","title":{"rendered":"Politica LLR pentru amigdalectomie \u0219i adenoidectomie\u00a0"},"content":{"rendered":"

<\/p>\n\n\n\n

Categoria<\/strong><\/p>\n\n\n\n

Criterii de prag<\/p>\n\n\n\n

Amigdalele sunt situate pe p\u0103r\u021bile laterale ale g\u00e2tului \u0219i fac parte din sistemul imunitar. Este nevoie de ele \u00een primul an de via\u021b\u0103, dar dup\u0103 aceea sunt redundante. La unii oameni, acestea sunt suprareactive \u0219i devin prea mari. Acest lucru poate provoca sfor\u0103it, respira\u021bie pe gur\u0103 \u0219i chiar apnee obstructiv\u0103 de somn. De asemenea, pot prinde bacterii precum streptococul \u0219i pot cauza faringite streptococi recurente.<\/p>\n\n\n\n

Cel mai frecvent motiv pentru \u00eendep\u0103rtarea amigdalelor este apneea obstructiv\u0103 \u00een somn din cauza dimensiunii mari a amigdalelor. Alte motive pentru a elimina amigdalele sunt infec\u021biile streptococi recurente, abcesul peri-amigdalian, durerea cronic\u0103 \u00een g\u00e2t sau, la adul\u021bi, suspiciunea de cancer. \u00cendep\u0103rtarea amigdalelor nu sl\u0103be\u0219te sistemul imunitar.<\/p>\n\n\n\n

Adenoidele sunt similare cu amigdalele. Sunt situate \u00een partea din spate a g\u00e2tului, deasupra gurii. Ele sunt de obicei \u00eendep\u0103rtate la copii \u00een acela\u0219i timp cu amigdalele, deoarece pot provoca \u0219i blocarea respira\u021biei.<\/p>\n\n\n\n

Eligibilitatea pentru amigdalectomie la adul\u021bi \u0219i copii<\/strong><\/p>\n\n\n\n

<\/p>\n\n\n\n

LLR ICB va finan\u021ba o amigdalectomie dac\u0103 sunt prezen\u021bi urm\u0103torii indicatori clinici<\/strong>
\u00a0
\u00b7 Abces peri- amigdalian
\u00b7 Obstruc\u021bie acut\u0103 a c\u0103ilor aeriene superioare
\u00b7 Dureri recurente \u00een g\u00e2t \u00een cazul \u00een care una dintre urm\u0103toarele a fost documentat\u0103
\u2013 7 sau mai multe episoade \u00een ultimul an
\u2013 5 sau mai multe episoade \u00een ultimii doi ani
\u2013 3 sau mai multe episoade \u00een fiecare din ultimii trei ani

\u0218I <\/strong>
\u00b7 Impact sever semnificativ asupra calit\u0103\u021bii vie\u021bii indicat de
\u2013 Absen\u021ba de la serviciu
\u2013 Absen\u021ba de la \u0219coal\u0103
- Incapacitatea de a prospera

\u0218I una dintre urm\u0103toarele <\/strong>

o Temperatura auditiv\u0103 de cel pu\u021bin 38,3C
o Ganglioni limfatici cervicali anteriori sensibili
o Exsudatele amigdalelor
o Cultur\u0103 pozitiv\u0103 a streptococilor beta hemolitici de grup A
o Episoadele sunt dezactivate \u0219i \u00eempiedic\u0103 func\u021bionarea normal\u0103
o M\u0103rirea amigdalelor care duce la simptome de obstruc\u021bie<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

<\/p>\n\n\n\n

LLR ICB va finan\u021ba amigdalectomia \u00een sindromul de apnee \u00een somn la copii atunci c\u00e2nd se aplic\u0103 una sau mai multe dintre urm\u0103toarele<\/strong>
\u00a0<\/strong>
\u00b7 Studiu pozitiv al somnului
SAU<\/strong>
\u00b7 Impact semnificativ asupra calit\u0103\u021bii vie\u021bii demonstrat
SAU<\/strong>
\u00b7 Istoric clinic puternic care sugereaz\u0103 apnee \u00een somn<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Eligibilitatea pentru adenoidectomie la copii<\/strong><\/p>\n\n\n\n

LLR ICB va finan\u021ba adenoidectomia la copiii \u00een care sunt \u00eendeplinite urm\u0103toarele indica\u021bii clinice<\/strong>
\u00a0<\/strong>
\u00b7 Copii cu otit\u0103 medie cu rev\u0103rsat (OME) care \u00eendeplinesc recomand\u0103rile NICE pentru tuburile de ventila\u021bie (ochiuri) \u00een prezen\u021ba infec\u021biilor persistente \u0219i\/sau frecvente ale tractului respirator superior

SAU<\/strong>
\u00b7 Pentru tulbur\u0103ri de respira\u021bie \u00een somn la copii care sunt diagnosticate clinic. Urm\u0103torul impact asupra dezvolt\u0103rii trebuie documentat
\u2013 comportament de exemplu hiperactivitate, somnolen\u021b\u0103 \u00een timpul zilei
\u2013 calitatea vie\u021bii de exemplu \u00een\u0103l\u021bimea \u0219i greutatea
\u2013 obstruc\u021bie nazal\u0103
\u2013 dimensiunea adenoidelor

SAU<\/strong>
\u2013 studiul somnului (\u00een prezen\u021ba adenoidelor excesiv de mari)<\/td><\/tr><\/tbody><\/table>

\u00cendrumare<\/strong><\/figcaption><\/figure>\n\n\n\n

<\/p>\n\n\n\n

Amigdalectomie pentru amigdalita recurent\u0103 \u2013 EBI (aomrc.org.uk)<\/a>
\u00a0
Op\u021biuni NHS \u2013 Amigdalita
http:\/\/www.nhs.uk\/conditions\/tonsillitis\/Pages\/Introduction.aspx<\/a> \u00a0
\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
Data revizuirii LLR ARP 91: 2026<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"

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