鼻用激素类药物在儿童急性分泌性中耳炎治疗中的应用
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摘要
目的探讨鼻用激素类药物在儿童急性分泌性中耳炎治疗中的作用,观察临床疗效。方法将75例急性分泌性中耳炎患儿随机分为两组,治疗组患儿37例,对照组患儿38例。两组均口服头孢二代抗生素、粘液促排剂欧龙马,并使用外耳道局部理疗;治疗组采用鼻用激素类药物喷鼻,对照组采用0.5%麻黄素滴鼻剂点鼻。治疗周期均为14 d,复查恢复情况,检查结果通过SPSS13.0检验,并用VAS视觉模拟评分法评价患儿使用鼻喷剂或麻黄碱滴鼻剂的耐受程度,对检查结果行t检验。结果治疗一周后治疗组治愈率70.3%,对照组治愈率44.7%,治疗两周后治疗组治愈率89.2%,对照组治愈率65.8%,对检查结果进行卡方检验,P值<0.05;对儿童用药耐受度进行VAS视觉评分记录并对检查结果进行t检验;P值<0.05,差别有统计学意义。结论应用糖皮质激素治疗儿童急性分泌性中耳炎能缩短治疗流程,提高治愈率,使用方便,儿童耐受度好,值得临床推广。
Objective To explore the role of nasal hormones in the treatment of acute secretory otitis media in children and observe the clinical efficacy. Methods 75 children with acute secretory otitis media were randomly divided into two groups, 37 in the treatment group and 38 in the control group. Both groups were treated with cephalosporin II antibiotics, mucus excretion enhancer Ouroma,and local physical therapy of external auditory canal. The treatment group was treated with nasal hormone drugs, while the control group was treated with 0.5% ephedrine nasal drops. The treatment period was 14 days. The recovery was reexamined. The results were tested by SPSS13.0. The tolerance of children to nasal spray or ephedrine nasal drops was evaluated by VAS visual analogue score. The results were tested by t test. Results The cure rate was 70.3% in the treatment group and 44.7% in the control group after one week of treatment,89.2% in the treatment group and 65.8% in the control group after two weeks of treatment. Chi-square test was performed on the test results, P value was 0.05; VAS visual score was recorded on the tolerance of children to medication and t test results were performed on t test; P value was 0.05, the difference was statistically significant. Conclusion Glucocorticoids can shorten the treatment process, improve the cure rate, be easy to use and have good tolerance in children with acute secretory otitis media, which is worthy of clinical promotion.
Objective To explore the role of nasal hormones in the treatment of acute secretory otitis media in children and observe the clinical efficacy. Methods 75 children with acute secretory otitis media were randomly divided into two groups, 37 in the treatment group and 38 in the control group. Both groups were treated with cephalosporin II antibiotics, mucus excretion enhancer Ouroma,and local physical therapy of external auditory canal. The treatment group was treated with nasal hormone drugs, while the control group was treated with 0.5% ephedrine nasal drops. The treatment period was 14 days. The recovery was reexamined. The results were tested by SPSS13.0. The tolerance of children to nasal spray or ephedrine nasal drops was evaluated by VAS visual analogue score. The results were tested by t test. Results The cure rate was 70.3% in the treatment group and 44.7% in the control group after one week of treatment,89.2% in the treatment group and 65.8% in the control group after two weeks of treatment. Chi-square test was performed on the test results, P value was 0.05; VAS visual score was recorded on the tolerance of children to medication and t test results were performed on t test; P value was 0.05, the difference was statistically significant. Conclusion Glucocorticoids can shorten the treatment process, improve the cure rate, be easy to use and have good tolerance in children with acute secretory otitis media, which is worthy of clinical promotion.
引文
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[5]陈敏,胡艳玲,张丰珍等.急性中耳炎儿童使用抗生素与否的疗效分析[J].听力学及言语疾病杂志,2015(5):473-476.
[6]吕金霞.头孢曲松和阿莫西林用于儿童急性中耳炎治疗的对比分析[J].医药前沿,2015(16):80-81.
[7]王春芳,刘争,黄孝文,等.糖皮质激素对急性中耳炎中耳积液影响的研究[J].临床耳鼻咽喉头颈外科杂志,2007,21(4):167-168.
[8]谭新华.呋麻滴鼻液辅助治疗儿童急性中耳炎的效果观察[J].中外医疗,2011,30(32):43-43.
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[12]徐淑芳,张全福,刘俊英,et al.唐山市急性上呼吸道感染继发急性中耳炎患儿临床治疗分析[J].湖南师范大学学报(医学版),2016,13(2):107-110.
[13]瞿艳红.头孢地尼治疗儿童急性中耳炎的疗效观察[J].当代医药论丛,2012,10(9):154-154.
[14]何淑琼,张雁.头孢哌酮钠舒巴坦钠与头孢曲松钠对急性中耳炎的疗效对比分析[J].医学信息,2014(6):124-124.
[15]肖南昌,卢晓华,许慕岚.阿奇霉素与阿莫西林-克拉维酸对儿童患者急性中耳炎抗感染治疗的疗效比较[J].抗感染药学,2017(3):600-602.
[16]孔维佳,王斌全主编.耳鼻咽喉科学[M].北京:人民卫生出版社,2001:457-458.
[17]汪健全,江进波.综合治疗儿童分泌性中耳72例[J].中国医疗前沿,2007,2(17):54.
[18]Doyle WJ.The link between allergic rhinitis and otitis media.Curr Opin Allergy Clin Immunol,2002,2:21-25.
[19]田君海,路虹,刘艳海,等.分泌性中耳炎中耳积液嗜酸性细胞阳离子蛋白与IgE测定.临床耳鼻咽喉科杂志,2006,20:449-453.
[20]陈穗俊,梁象逢,郑亿庆,等.白介素-2在分泌性中耳炎中的意义.中华耳科学杂志,2005,3:93-96.
[21]MinYG,YunYs,RheeCS,etla,Efects of phenep hrine on ciliary beat in human nasal espiratory epitheifam:quantitmive measurement by video-computerized analysis Laryngoscope,1998,108(3):418-421.
[22]张全安,张青,高琼,等.分泌性中耳炎诊治预防新理念及策略[J].中国科技论文在线,2007,2(11):814-818.
[2]Ryding M,White P,Kalm O.Eustachian tube function nand tympatic membrane findings after chronic secretory otitis media[J].Int J Pediatrotorhinolaryngol,2004,68(2):197.
[3]张江平,杨妙丽,张金安(译文).国外医学耳鼻喉科学分册,2005,29(3):141.
[4]杨丽,艾文彬,罗琴.头孢地尼与阿莫西林克拉维酸钾治疗儿童急性中耳炎的临床观察[J].中南医学科学杂志,2015(2):188-191.
[5]陈敏,胡艳玲,张丰珍等.急性中耳炎儿童使用抗生素与否的疗效分析[J].听力学及言语疾病杂志,2015(5):473-476.
[6]吕金霞.头孢曲松和阿莫西林用于儿童急性中耳炎治疗的对比分析[J].医药前沿,2015(16):80-81.
[7]王春芳,刘争,黄孝文,等.糖皮质激素对急性中耳炎中耳积液影响的研究[J].临床耳鼻咽喉头颈外科杂志,2007,21(4):167-168.
[8]谭新华.呋麻滴鼻液辅助治疗儿童急性中耳炎的效果观察[J].中外医疗,2011,30(32):43-43.
[9]杨丽,艾文彬,罗琴.儿童急性中耳炎声导抗随访观察[J].实用医学杂志,2015(9)
[10]阎承先.小儿耳鼻咽喉科学.第2版.天津:天津科学技术出版社,2000:73-86.192-198
[11]康瑜.腺样体切除术联合鼓膜切开治疗儿童分泌性中耳炎60例临床效果分析[J].中国医药指南,2017,15(31):46-46
[12]徐淑芳,张全福,刘俊英,et al.唐山市急性上呼吸道感染继发急性中耳炎患儿临床治疗分析[J].湖南师范大学学报(医学版),2016,13(2):107-110.
[13]瞿艳红.头孢地尼治疗儿童急性中耳炎的疗效观察[J].当代医药论丛,2012,10(9):154-154.
[14]何淑琼,张雁.头孢哌酮钠舒巴坦钠与头孢曲松钠对急性中耳炎的疗效对比分析[J].医学信息,2014(6):124-124.
[15]肖南昌,卢晓华,许慕岚.阿奇霉素与阿莫西林-克拉维酸对儿童患者急性中耳炎抗感染治疗的疗效比较[J].抗感染药学,2017(3):600-602.
[16]孔维佳,王斌全主编.耳鼻咽喉科学[M].北京:人民卫生出版社,2001:457-458.
[17]汪健全,江进波.综合治疗儿童分泌性中耳72例[J].中国医疗前沿,2007,2(17):54.
[18]Doyle WJ.The link between allergic rhinitis and otitis media.Curr Opin Allergy Clin Immunol,2002,2:21-25.
[19]田君海,路虹,刘艳海,等.分泌性中耳炎中耳积液嗜酸性细胞阳离子蛋白与IgE测定.临床耳鼻咽喉科杂志,2006,20:449-453.
[20]陈穗俊,梁象逢,郑亿庆,等.白介素-2在分泌性中耳炎中的意义.中华耳科学杂志,2005,3:93-96.
[21]MinYG,YunYs,RheeCS,etla,Efects of phenep hrine on ciliary beat in human nasal espiratory epitheifam:quantitmive measurement by video-computerized analysis Laryngoscope,1998,108(3):418-421.
[22]张全安,张青,高琼,等.分泌性中耳炎诊治预防新理念及策略[J].中国科技论文在线,2007,2(11):814-818.