舌下特异性免疫治疗过程中儿童鼻出血次数降低的临床分析  

Clinical analysis of the reduction in the number of occurrences of epistaxis in children during sublingual specific immunotherapy

作　　者：周雅利 李王伟 李静 ZHOU Yai;LI Wangwei;Li Jing(Department of Otolaryngology,the Affiliated Jiangning Hospital of Nanjing Medical University,Jiangsu,Nanjing 211100,China)

机构地区：[1]南京医科大学附属江宁医院耳鼻咽喉科,江苏南京211100

出　　处：《中国医药科学》2024年第22期158-161,180,共5页China Medicine And Pharmacy

基　　金：南京市卫生科技发展专项资金资助项目(YKK22217)。

摘　　要：目的探讨标准化粉尘螨滴剂舌下特异性免疫治疗儿童变应性鼻炎过程中鼻出血发生次数降低的原因。方法对南京医科大学附属江宁医院耳鼻咽喉科2020年1月至2021年12月123例皮肤点刺实验结果阳性++及以上的变应性鼻炎伴有鼻出血的患儿进行标准化粉尘螨滴剂舌下特异性免疫治疗。评估治疗前、治疗6个月、治疗1年、治疗2年患儿的鼻部症状总评分、药物总评分、症状药物联合评分、视觉模拟评分法评分、鼻出血症状评分、鼻内镜下鼻腔黏膜改变状况及不良反应。结果舌下特异性免疫治疗变应性鼻炎伴有鼻出血的患儿2年后,鼻部症状总评分、药物总评分、症状药物联合评分、视觉模拟量表及鼻出血症状评分均低于治疗前,差异有统计学意义(P<0.05)。治疗后鼻内镜可见鼻腔黏膜变红润,利氏区黏膜糜烂较前好转、血管增粗弯曲裸露的状态较前好转。结论变应性鼻炎伴有鼻出血的患儿进行舌下特异性免疫治疗的过程中,可降低鼻出血发生次数,改善鼻腔黏膜状况,长期疗效显著,无明显不良反应。Objective To investigate the analysis on reasons for the reduction in the number of occurrences of epistaxis during sublingual specific immunotherapy with standardized dermatophagoides farinae drops for allergic rhinitis in children.Methods A total of 123 children with allergic rhinitis confirmed by skin prick test results of positive++and above accompanied by epistaxis admitted to the Department of Otolaryngology of the Affiliated Jiangning Hospital of Nanjing Medical University from January 2020 to December 2021 had received sublingual specific immunotherapy with standardized dermatophagoides farinae drops.They were assessed for total nasal symptom score,total medication score,combined symptom and medication score,visual analog scale,epistaxis symptom score,nasal mucosal changes under nasal endoscope,and adverse reactions before treatment and at 6 months of treatment,1 year of treatment,and 2 years of treatment.Results After 2 years of sublingual specific immunotherapy for children with allergic rhinitis accompanied by epistaxis,the total nasal symptom score,total medication score,combined symptom and medication score,visual analog scale,and epistaxis symptom score were lower than those before the treatment,with statistically significant differences(P<0.05).After treatment,nasal endoscopy showed that the nasal mucosa became reddish and moist,with the mucosal erosion in the little’s area and the condition of thickened,curved and exposed blood vessels improved compared with before.Conclusion The process of sublingual specific immunotherapy in children with allergic rhinitis accompanied by epistaxis reduces the number of occurrences of epistaxis and improves the condition of the nasal mucosa,with significant long-term efficacy and no significant adverse reactions.

关 键 词：舌下免疫治疗 变应性鼻炎 鼻出血 儿童 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]