摘要
目的探讨药物治疗和手术治疗对不同程度的腺样体肥大合并变应性鼻炎(AR)患儿的临床疗效。方法分析2017年6月~2018年6月在重庆医科大学附属儿童医院耳鼻咽喉头颈外科治疗的腺样体肥大伴AR儿童187例,根据腺样体肥大程度分为3组。采用视觉模拟量表对患儿药物及手术治疗前后的阻塞症状(打鼾、张口呼吸、鼻阻)及过敏症状(流涕、鼻痒、打喷嚏)进行评估,并比较药物治疗前后腺样体A/N。结果接受3个月正规药物治疗的43例轻度腺样体肥大伴AR患儿,腺样体A/N、打鼾、张口呼吸、鼻阻、流涕、鼻痒、打喷嚏症状评分均明显好转(t分别为5.472、8.968、7.670、10.726、3.838、2.351、4.946,P均<0.05);中、重度腺样体肥大伴AR患儿,腺样体A/N及各症状评分在药物治疗前后,差异均无统计学意义(P>0.05)。对药物治疗效果欠佳患儿行腺样体切除术并继续抗过敏治疗,术后随访患儿阻塞及过敏症状评分均好转。结论AR与腺样体肥大关系密切,对于轻度患儿可以坚持药物治疗,避免手术;而对于中重度患儿可先抗过敏药物治疗,效果欠佳再行手术,术后对AR仍需继续药物治疗。
OBJECTIVE To explore the clinical efficacy of medication and surgical treatment for children with adenoid hypertrophy and allergic rhinitis.METHODSThe clinical data of 187 children with adenoid hypertrophy with allergic rhinitis treated in our hospital from June 2017 to June 2018 were analyzed.All children were divided into three groups according to the degree of adenoid hypertrophy.Visual analog scale was used to evaluate the symptoms of obstruction(snoring,mouth breathing,nasal obstruction)and allergic symptoms(runny nose,nose itching,sneezing)before and after treatment,and compare the adenoid A/N value after drug treatment.RESULTS Adenoid A/N valueand the scores of obstructive and allergic symptoms were significantly improved in the group of mild adenoid hypertrophy with allergic rhinitis(43 cases),but there was no statistical significance in groups of moderate and severe adenoid hypertrophy(144 cases)after medication for 3 months.Therefore,adenoidectomy and continued anti-allergic treatment was taken in the children with moderate and severe adenoid hypertrophy after the ineffective treatment.The scores of obstructive and allergic symptoms of the children were improved after operation.CONCLUSION Allergic rhinitis is closely related to adenoid hypertrophy.Children with mild adenoid hypertrophy can be treated with anti-allergic drugs and avoid surgery.For the moderate and severe cases,adenoidectomy and regular postoperative ant-allergic treatment for a long time should be taken.
作者
肖玲
杜小芳
姚红兵
王冰
XIAO Ling;DUXiaofang;YAO Hongbing;WANG Bing(Department of Otolaryngology Head and Neck Surgery,Children's Hospital of Chongqing Medical University,Chongqing Key of Laboratory of Pediatrics,Ministry of Education Key Laboratory of Child Development Disease Research,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,National Clinical Research Center for Child Health and Disorders,Chongqing,400014,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2020年第12期709-711,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
儿童
鼻炎
变应性
季节性
治疗结果
腺样体肥大
Child
Rhinitis
Allergic
Seasonal
Treatment Outcome
adenoid hypertrophy
