鼻用糖皮质激素在腺样体肥大性小儿鼾症中的应用探讨  

Application of Nasal Glucocorticoids in Adenoid Hypertrophic Pediatric Hysteria

作　　者：许建华 林力 寿铸 包长兵 杨艺 XU Jian-hua;LIN Li;SHOU Zhu;BAO Chang-bing;YANG Yi(Department of Otolaryngology,People's Hospital of Yubei District,Chongqing,401120 China;Department of Radiology,People's Hospital of Yubei District,Chongqing,401120 China)

机构地区：[1]重庆市渝北区人民医院耳鼻咽喉科,重庆401120 [2]重庆市渝北区人民医院放射科,重庆401120

出　　处：《中外医疗》2019年第23期108-110,共3页China & Foreign Medical Treatment

摘　　要：目的对鼻用糖皮质激素在腺样体肥大性小儿鼾症中的应用效果进行分析和讨论。方法该次50例研究对象均为方便选取该院2008年8月-2016年8月接收的小儿鼾症患儿,经过鼻咽侧位片检查被确诊为腺样体肥大,与此同时给予患儿丙酸氟替卡松鼻喷雾剂进行治疗,对比治疗前后腺体大小、腺样体中度肥大患儿治疗前后症状评分以及腺样体重度肥大治疗前后症状评分。结果治疗前,50例患儿a/N平均为(0.74±0.08),治疗后,腺样体a/N平均为(0.69±0.11),治疗后显著优于治疗前,两组数据比较,差异有统计学意义(t=2.599,P=0.010);对于腺样体中度肥大患儿而言,治疗后患儿的鼻塞症状评分为(1.18±0.53)分,与治疗前(3.39±1.03)分相比显著较低(t=13.491,P=0.000);治疗后患儿的张口呼吸症状评分为(1.80±0.74)分,与治疗前(2.12±0.95)分相比差异无统计学意义(t=1.879,P=0.063);治疗后患儿的打鼾症状评分为(1.74±0.85)分,与治疗前(3.14±0.63)分相比显著较低(t=9.357,P=0.000);治疗后患儿的呼吸暂停症状评分为(1.43±0.72)分,与治疗前(2.18±0.90)分相比显著较低(t=4.601,P=0.000);对于重度腺样体重度肥大患儿而言,均有所改善,治疗后患儿的张口呼吸症状评分为(2.44±1.23)分,与治疗前(2.51±1.08)分相比差异无统计学意义(t=0.302,P=0.763);治疗后患儿的打鼾症状评分为(3.23±0.91)分,与治疗前(3.49±0.64)分相比差异无统计学意义(t=1.653,P=0.102);治疗后患儿的呼吸暂停症状评分为(3.53±0.92)分,与治疗前(3.72±0.62)分相比差异无统计学意义(t=1.211,P=0.229);在鼻塞方面,治疗前(3.37±1.10)分和治疗后(2.56±0.93)分差异有统计学意义(t=3.976,P=0.000)。结论将鼻用糖皮质激素应用于腺样体肥大小儿鼾症治疗之中,可有效改善患儿临床症状,对于重度腺样体肥大患儿而言,如果鼻用糖皮质激素治疗效果不理想,则可以采用手术方式进行治疗。Objective To analyze and discuss the application of nasal glucocorticoids in adenoid hypertrophic rickets.Methods Convenient select 50 subjects were all children with snoring in the hospital from August 2008 to August 2016.They were diagnosed as adenoid hypertrophy after sphincter lateral examination.The fluticasone nasal spray was used to treat the gland size,the symptom scores of the children with adenoid moderate hypertrophy before and after treatment,and the symptom scores before and after treatment with adenoid mass hypertrophy.Results Before treatment,the average a/N of 50 patients was (0.74±0.08)points.After treatment,the a/N of adenoids was (0.69±0.11)points.After treatment,it was significantly better than before,and the difference was statistically significant(t=2.599,P=0.01).For children with adenoid moderate hypertrophy,the nasal congestion symptom score was (1.18±0.53)points after treatment,compared with before treatment (3.39±1.03)points.The ratio was significantly lower(t=13.491,P=0.000).The postoperative respiratory symptoms score was (1.80±0.74)points,and there was no significant difference compared with the pretreatment (2.12±0.95)points(t=1.879,P=0.063).The snoring symptom score of the children after treatment was (1.74±0.85)points,which was significantly lower than that before treatment (3.14±0.63)porints(t=9.357,P=0.000).The apnea symptom score of the children after treatment was (1.43±0.72)points,which was significantly lower than that before treatment (2.18±0.90)points(t=4.601,P=0.000) for severe In children with adenoid-weight hypertrophy,all have improved,and the mouth of the child after treatment symptom score was (2.44±1.23),and there was no significant difference compared with before treatment (2.51±1.08)points.(t=0.302,P=0.763).The snoring symptom score of the children after treatment was (3.23±0.91)points.There was no significant difference compared with before treatment (3.49±0.64)points(t=1.653,P= 0.102).The apnea symptom score of the children after treatment was (3.53

关 键 词：打鼾 鼻用激素 腺样体肥大 

分 类 号：R766[医药卫生—耳鼻咽喉科]