腺样体切除术后对儿童鼻窦炎治疗转归的影响
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摘要
目的探讨儿童鼻窦炎行鼻内镜下腺样体切除术对疾病转归的影响。方法以2013年1月—2018年12月为时限,方便择取该院耳鼻咽喉科收治的61例鼻窦炎患儿为研究对象,全部患儿均伴有不同程度的腺样体肥大,于全麻鼻内镜下行腺样体切除术,术后予以鼻用固醇类激素喷雾等药物治疗。随访观察患儿临床症状改善情况,评价鼻窦炎治疗效果,统计手术并发症与复发率。结果随访观察,全部患儿术后腺样体肥大症状均明显改善(100.00%),夜眠打鼾、张口呼吸等症状基本于术后1个月内消失。55例患儿术后可见黄白色脓涕自鼻腔流出(90.16%),鼻塞得到明显缓解。鼻窦炎治疗显效45例,有效12例,无效4例,治疗总有效率93.44%,术后并发症发生率0.00%,随访复发率0.00%。结论腺样体切除术是治疗儿童鼻窦炎合并腺样体肥大的有效方法 ,辅以系统鼻窦炎药物治疗,可有效改善患儿临床症状,促进鼻腔通气恢复正常,应用安全有效,可作为鼻窦炎伴腺样体肥大保守治疗无效患儿的首选治疗方法,值得临床推广。
Objective To investigate the effect of endoscopic adenoidectomy on the outcome of children with sinusitis.Methods From January 2013 to December 2018, 61 children with sinusitis admitted to our hospital were enrolled in the Department of Otorhinolaryngology. All children were accompanied by different degrees of adenoid hypertrophy. Nasal endoscopic adenoidectomy, postoperative nasal steroid hormone spray and other drugs. Follow-up observation of the improvement of clinical symptoms in children, evaluation of the treatment effect of sinusitis, statistics of surgical complications and recurrence rate. Results After follow-up observation, the symptoms of postoperative adenoid hypertrophy were significantly improved in all children(100.00%). Symptoms such as night snoring and mouth breathing disappeared within 1 month after surgery. In 55 patients, yellowish white purulent sputum(90.16%) was seen from the nasal cavity, and the nasal congestion was significantly relieved. Sinusitis treatment was effective in 45 cases, effective in 12 cases, ineffective in 4 cases, the total effective rate was 93.44%, the postoperative complication rate was 0.00%, and the recurrence rate was 0.00%. Conclusion Adenoidectomy is an effective method for the treatment of sinusitis and adenoid hypertrophy in children. It is supplemented with systemic sinusitis drug treatment, which can effectively improve the clinical symptoms of children, promote the normalization of nasal ventilation, safe and effective application, and can be used as sinusitis. The preferred treatment for children with ineffective adenoid hypertrophy is worthy of clinical promotion.
Objective To investigate the effect of endoscopic adenoidectomy on the outcome of children with sinusitis.Methods From January 2013 to December 2018, 61 children with sinusitis admitted to our hospital were enrolled in the Department of Otorhinolaryngology. All children were accompanied by different degrees of adenoid hypertrophy. Nasal endoscopic adenoidectomy, postoperative nasal steroid hormone spray and other drugs. Follow-up observation of the improvement of clinical symptoms in children, evaluation of the treatment effect of sinusitis, statistics of surgical complications and recurrence rate. Results After follow-up observation, the symptoms of postoperative adenoid hypertrophy were significantly improved in all children(100.00%). Symptoms such as night snoring and mouth breathing disappeared within 1 month after surgery. In 55 patients, yellowish white purulent sputum(90.16%) was seen from the nasal cavity, and the nasal congestion was significantly relieved. Sinusitis treatment was effective in 45 cases, effective in 12 cases, ineffective in 4 cases, the total effective rate was 93.44%, the postoperative complication rate was 0.00%, and the recurrence rate was 0.00%. Conclusion Adenoidectomy is an effective method for the treatment of sinusitis and adenoid hypertrophy in children. It is supplemented with systemic sinusitis drug treatment, which can effectively improve the clinical symptoms of children, promote the normalization of nasal ventilation, safe and effective application, and can be used as sinusitis. The preferred treatment for children with ineffective adenoid hypertrophy is worthy of clinical promotion.
引文
[1]阳海林,张国旺,田超逸.腺样体切除术后对儿童鼻窦炎治疗转归的影响分析[J].中外医学研究,2018,16(33):166-167.
[2]庄强尔,邹凤,杜虹,等.腺样体切除术联合药物治疗对慢性鼻-鼻窦炎患儿疗效及生活质量的影响[J].贵州医药,201842(10):1200-1201.
[3]王胜国,毕竞韬,周本忠,等.儿童慢性鼻-鼻窦炎个体化治疗探讨[J].临床小儿外科杂志,2017,16(6):595-600.
[4]张玉杰,郝晓伟,李畅,等.经口鼻内镜下低温等离子腺样体铲切术疗效分析[J].临床耳鼻咽喉头颈外科杂志,2018,32(23):1829-1831.
[5]马淑巍,陈洁.腺样体切除术治疗儿童慢性鼻-鼻窦炎的疗效分析[J].河北医学,2018,24(9):1501-1504.
[6]Suh MW,Jin HR,Kim JH,et al.Computed tomography versus nasal endoscopy for the measurement of the internal nasal valve angle in Asians[J].Acta Oto-Laryngologica,2015,128(6):675-679.
[7]姚敏,叶辉,叶伟伟,等.腺样体切除术后规范化治疗对儿童鼻-鼻窦炎转归的影响[J].齐齐哈尔医学院学报,2017,38(20)2414-2416.
[8]朱恒才,程雷,史祥伟,等.腺样体肥大融切术后对儿童鼻窦炎治疗转归的影响[J].中国中西医结合耳鼻咽喉科杂志2014,22(1):43-46.
[9]Gregory S Neel,Ryan L Kau,Stephen F.Bansberg,Devyani Lal.Comparison of 3 mm versus 4 mm rigid endoscope in diagnostic nasal endoscopy[J].World Journal of Otorhinolaryngology-Head and Neck Surgery,2017,35(9):224-227.
[10]柴向华,廖光美,吕洁文.观察鼻内镜下腺样体切除术对儿童慢性鼻窦炎的效果[J].中国现代药物应用,2018,12(14)13-15.
[2]庄强尔,邹凤,杜虹,等.腺样体切除术联合药物治疗对慢性鼻-鼻窦炎患儿疗效及生活质量的影响[J].贵州医药,201842(10):1200-1201.
[3]王胜国,毕竞韬,周本忠,等.儿童慢性鼻-鼻窦炎个体化治疗探讨[J].临床小儿外科杂志,2017,16(6):595-600.
[4]张玉杰,郝晓伟,李畅,等.经口鼻内镜下低温等离子腺样体铲切术疗效分析[J].临床耳鼻咽喉头颈外科杂志,2018,32(23):1829-1831.
[5]马淑巍,陈洁.腺样体切除术治疗儿童慢性鼻-鼻窦炎的疗效分析[J].河北医学,2018,24(9):1501-1504.
[6]Suh MW,Jin HR,Kim JH,et al.Computed tomography versus nasal endoscopy for the measurement of the internal nasal valve angle in Asians[J].Acta Oto-Laryngologica,2015,128(6):675-679.
[7]姚敏,叶辉,叶伟伟,等.腺样体切除术后规范化治疗对儿童鼻-鼻窦炎转归的影响[J].齐齐哈尔医学院学报,2017,38(20)2414-2416.
[8]朱恒才,程雷,史祥伟,等.腺样体肥大融切术后对儿童鼻窦炎治疗转归的影响[J].中国中西医结合耳鼻咽喉科杂志2014,22(1):43-46.
[9]Gregory S Neel,Ryan L Kau,Stephen F.Bansberg,Devyani Lal.Comparison of 3 mm versus 4 mm rigid endoscope in diagnostic nasal endoscopy[J].World Journal of Otorhinolaryngology-Head and Neck Surgery,2017,35(9):224-227.
[10]柴向华,廖光美,吕洁文.观察鼻内镜下腺样体切除术对儿童慢性鼻窦炎的效果[J].中国现代药物应用,2018,12(14)13-15.