儿童腺样体肥大合并慢性鼻窦炎的临床疗效分析

Analysis on the clinical efficacy of adenoid hypertrophy complicated with chronic sinusitis in children

目的探讨儿童腺样体肥大合并慢性鼻窦炎的治疗效果。方法选择我院98例2017年1月~2019年2月儿童腺样体肥大合并慢性鼻窦炎。随机分组,每组各49例,单纯药物治疗组实施糠酸莫米松喷鼻剂,生理盐水洗鼻治疗,手术组给予糠酸莫米松喷鼻剂药物联合腺样体切除手术和生理盐水洗鼻治疗。比较两组儿童腺样体肥大合并慢性鼻窦炎疗效;治疗前后患儿慢性鼻窦炎症状及鼻内镜检查评分以及不良反应等指标。结果药物治疗联合腺样体切除手术组疗效高于单纯药物治疗组,差异有统计学意义(P<0.05)。其中,药物治疗联合腺样体切除手术组治疗显效34例,治疗有效15例,总有效率为100.00%;单纯药物治疗组治疗显效19例,治疗有效16例,无效14例,总有效率为71.43%;治疗前单纯药物治疗组、药物治疗联合腺样体切除手术组慢性鼻窦炎症状及鼻内镜检查评分比较,差异无统计学意义(P>0.05);治疗后药物治疗联合腺样体切除手术组慢性鼻窦炎症状及鼻内镜检查评分变化幅度更大,差异有统计学意义(P<0.05)。药物治疗联合腺样体切除手术组和单纯药物治疗组不良反应相似,差异无统计学意义(P>0.05),其中,单纯药物治疗组1例不良反应。药物治疗联合腺样体切除手术组有2例不良反应。结论糠酸莫米松喷鼻剂、生理盐水洗鼻治疗联合腺样体切除手术治疗儿童腺样体肥大合并慢性鼻窦炎效果确切,可获得理想效果。

Objective To investigate the therapeutic efficacy of adenoid hypertrophy complicated with chronic sinusitis in children.Methods From January 2017 to February 2019,a total of 98 children with adenoid hypertrophy complicated with chronic sinusitis admitted to our hospital were selected and randomly divided into the single medication group(n=49)and the operation group(n=49).The single medication group was given mometasone furoate nasal spray and normal saline nasal washing treatment,while the operation group was given mometasone furoate nasal spray combined with adenoidectomy and normal saline nasal washing treatment.The therapeutic efficacies of adenoid hypertrophy complicated with chronic sinusitis in the two groups of children were compared.Before and after treatment,the symptoms of chronic sinusitis,scores of nasal endoscopies and adverse reactions(ADRs)of children were compared as well.Results The therapeutic efficacy of the group of medication combined with adenoidectomy was higher than that of the single medication group,and the difference was statistically significant(P<0.05).Among them,the group of medication combined with adenoidectomy was significantly effective in 34 cases and somewhat effective in 15 cases,with a total efficacy rate of 100.00%.The single medication group was significantly effective in 19 cases,somewhat effective in 16 cases,and ineffective in 14 cases,with a total efficacy rate of 71.43%.Before treatment,there were no statistically significant differences in symptoms of chronic sinusitis and scores of nasal endoscopies between the single medication group and the group of medication combined with adenoidectomy(P>0.05).After treatment,the symptoms of chronic sinusitis and the scores of nasal endoscopies in the group of medication combined with adenoidectomy changed more significantly(P<0.05).ADRs in the group of medication combined with adenoidectomy were similar to those of the single medication group,and there was no statistically significant difference(P>0.05).Among them,there was 1 case of ADRs in the single medication group,and 2 ADRs in the group of medication combined with adenoidectomy.Conclusion Mometasone furoate nasal spray,normal saline nasal washing treatment combined with adenoidectomy are definitely effective on children with adenoid hypertrophy complicated with chronic sinusitis,and ideal results could be obtained.