上颌窦穿刺冲洗治疗儿童急慢性鼻窦炎的效果分析

Analysis on effect of puncture and irrigation of maxillary sinus in treatment of acute and chronic nasosinusitis in children and relevant nursing

目的分析上颌窦穿刺冲洗治疗儿童急慢性鼻窦炎的临床疗效。方法将320例儿童（7~12岁）急慢性鼻窦炎患者采用随机平行试验设计,分为实验组160例和对照组160例,两组均服用鼻窦炎口服液1次10 m l,每日3次,实验组在鼻腔黏膜麻醉下行上颌窦穿刺,用0.9%氯化钠溶液加甲硝唑注射液反复冲洗后,窦腔内注入地塞米松5mg,每周一次;鼻腔内滴1%呋喃西林麻黄素液,3次/d,15 d为一个疗程。对照组口服广谱抗生素＋鼻腔内滴1%呋喃西林麻黄素液,3次/d,15 d为一个疗程。治疗结束后每月复查1次,6个月后进行疗效评定。结果实验组的治愈率84.38%,总有效率98.75%,均显著高于对照组,两组间比较有显著性差异（P〈0.01）。结论上颌窦穿刺冲洗结合鼻窦炎口服液治疗儿童急、慢性鼻窦炎疗效可靠,穿刺前充分评估患儿病情,实施健康教育,加强心理护理是上颌窦穿刺治疗顺利进行的基础,也是上颌窦穿刺成功的重要保证。

Objective To analyze the clinical efficacy and relevant nursing in treatment of acute and chronic nasosinusitis in children by puncture and irrigation of maxillary sinus.Methods Analysis on treatment of 320 patients with acute and chronic nasosinusitis（with age range of 7 to 12 years old） were carried out with randomized and parallel-designed method,they were divided into trial group（n=160） and control group（n=160）.Patients in both groups were taken with oral solution for sinusitis 10 ml tid.Patients in trial group were additionally received puncture of maxillary sinus under nasal mucosa anesthesia and repeatedly washing with metronidazole in 0.9% sodium chloride solution,and injection of dexamethasone（5 mg） into antrum after washing,once a week,and nasal drops of 1 % furacillin ephedrine solution,three times a day for 15 days as a therapeutic course.Patients in control group were applied with broad-spectrum antibiotics and nasal drops of 1 % furacillin ephedrine solution,three times a day for 15 days as a therapeutic course.All patients were followed up once a month.Results The cure rate of patients in trial group was 84.38% with a total effective rate of 98.75%.It was significantly higher than that of patients in control group（P0.01）.Conclusion The application with puncture and irrigation of maxillary sinus for treatment of acute and chronic nasosinusitis in children is reliable and effective.It is important to evaluate the severity of disease in childish patients before puncture,and implementing health education and offering psychological care can guarantee the success of treatment.