非手术方法治疗儿童腺样体肥大的临床观察

Non-surgical treatment for adenoidal hypertrophy

目的:探讨非手术方法治疗儿童腺样体肥大的可行性。方法:将57例腺样体肥大患儿分为实验T1组、T2组及对照组,分别应用鼻内糖皮质激素、白三烯受体拮抗剂及生理海水治疗12周,分析各组治疗前后腺样体大小及症状评分的变化。结果:T1和T2组在应用糖皮质激素喷鼻或口服白三烯受体拮抗剂治疗12周后,与对照组相比,临床症状显著改善,差异有统计学意义。T1及T2组腺样体的大小有相当程度的减小,而对照组无明显改变。T1与T2组疗效差异无统计学意义。结论:糖皮质激素喷鼻和口服白三烯受体拮抗剂对改善儿童腺样体肥大均可产生有益的作用,建议已有症状的腺样体肥大的学龄前儿童,在考虑手术治疗前,可首先应用鼻内糖皮质激素或白三烯受体拮抗剂治疗至少12周。

Objective：Study the practicability of non-surgical treatment for adenoidal hypertrophy.Method：Fifty-seven children were recruited in a randomized,placebo-controlled trial.Group T1 underwent intranasal corticosteroids treatment,group T2 underwent leukotriene receptor antagonists treatment,group C underwent placebo treatment：the records of 3 groups were analyzed.Result：After a 12-week treatment with intranasal corticosteroids or leukotriene receptor antagonists,group T1 and T2 patients demonstrated significant improvements in clinical symptoms and a more-pronounced reduction in adenoid size compared with control group patients,the difference was statistically significant.No statistically significant difference in group T1 and T2 patients.Conclusion：Intranasal corticosteroids and leukotriene receptor antagonists may be considered useful in decreasing adenoid pad size and the severity of symptoms related to adenoidal hypertrophy.Children with adenoidal hypertrophy should be considered for non-surgical treatment before surgery is planned.