Clinical research of transoral endoscopic adenoidectomy on the treatment of the adenoid hypertrophy children with chronic sinusitis
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摘要: 目的:分析经口内镜下腺样体切除手术在儿童不伴鼻息肉鼻-鼻窦炎治疗中的临床意义。方法:根据是否行腺样体切除术,将同时伴有慢性鼻窦炎与腺样体肥大的患儿分为手术组(43例)、对照组(40例)。全部研究对象治疗前、治疗3个月后均行鼻塞症状评分、流涕症状评分、鼻内镜评分及CT评分。结果:腺样体大小与鼻塞症状评分相关系数为0.38,有统计学意义(P<0.01);腺样体大小与流涕症状评分、鼻内镜评分及CT评分间均无统计学相关(P>0.05)。无论手术组或是对照组的鼻塞症状评分、流涕症状评分、鼻内镜评分及CT评分治疗前、后比较均有统计学差异(均P<0.05),治疗前高于治疗后。治疗后2组的鼻塞症状评分、流涕症状评分、鼻内镜评分及CT评分均有显著统计学差异(均P<0.01),手术组低于对照组。经过治疗,鼻塞症状评分、流涕症状评分、鼻内镜评分及CT评分的下降幅度在2组差异有统计学意义(均P<0.01),手术组下降幅度均远高于对照组。结论:经口内镜下腺样体切除结合鼻腔局部药物治疗能够大大提高儿童不伴鼻息肉鼻-鼻窦炎的疗效,具有重要临床意义。Abstract: Objective:To determine the clinical value of transoral endoscopic adenoidectomy for the pediatric sinusitis.Method:Patients with chronic sinusitis and adenoid hypertrophy were divided into two group by undertaken with or without adenoidectomy,the operation group with 43 cases and the control group with 40 cases.Evaluation was performed in pretherapy and after 3 months therapy.Evaluation index included symptom scale for nasal obstruction and rhinorrhea,endoscopy score and CT score for chronic sinusitis.Result:There was a positive correlation(0.38) between the adenoid size and the symptom of nasal obstruction(P<0.01).But there were no correlation between the adenoid size and the other index scores(P>0.05).Whether in the opearation group or the control group,all index scores in pretherapy were higher than in post-therapy(P<0.05).After 3 month therapy,all index scores in the opearation group were lower than the control group(P<0.01).The decreased amplitude of all index scores in the the opearation group were higher than the control group(P<0.01).Conclusion:Adenoidectomy combined with topical nasal treatment is one effective method for the pediatric sinusitis.Adenoidectomy paly an important role in the treatment of pediatric rhinosinusitis.
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Key words:
- transoral /
- adenoidectory /
- pediatric rhinosinusitis /
- bacterial biofilm
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[1] 周兵,马晶影,黄谦,等.少年儿童慢性鼻窦炎患者生存质量的影响因素[J].中华耳鼻咽喉头颈外科杂志,2006,41(12):915-918.
[2] STEELE R W.Chronic sinusitis in children[J].Clin Pe-diatr(Phila),2005,44:465-471.
[3] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻窦炎诊断和治疗指南(2008年,南昌)[J].中华耳鼻咽喉头颈外科杂志,2009,44(1):6-7.
[4] FIOCCHI A,SARRATUD T,BOUYGUE G R,et al.Topical treatment of rhinosinusitis[J].Pediatr AllergyImmunol,2007,18:62-67.
[5] 樊韵平,左可军,许庚,等.慢性鼻窦炎炎症状态的内镜评价和临床相关因素分析[J].中华耳鼻咽喉头颈外科杂志,2006,41(9):677-682.
[6] BERÇIN A S,URAL A,KUTLUHAN A,et al.Rela-tionship between sinusitis and adenoid size in pediatricage group[J].Ann Otol Rhinol Laryngol,2007,116:550-553.
[7] ARNAOUTAKIS D,COLLINS W O.Correlation of mu-cociliary clearance and symptomatology before and afteradenoidectomy in children[J].Int J Pediatr Otorhinolar-yngol,2011,75:1318-1321.
[8] TUNCER U,AYDOGAN B,SOYLU L,et al.Chronicrhinosinusitis and adenoid hypertrophy in children[J].Am J Otolaryngol,2004,25:5-10.
[9] COTICCHIA J,ZULIANI G,COLEMAN C,et al.Bio-film surface area in the pediatric nasopharynx:Chronicrhinosinusitis vs obstructive sleep apnea[J].Arch Oto-laryngol Head Neck Surg,2007,133:110-114.
[10] LIN C D,TSAI M H,LIN C W,et al.Association ofadenoid hyperplasia and bacterial biofilm formation inchildren with adenoiditis in Taiwan[J].Eur Arch Otorhi-nolaryngol,2012,269:503-511.
[11] SHIN K S,CHO S H,KIM K R,et al.The role of ade-noids in pediatric rhinosinusitis[J].Int J Pediatr Otorhi-nolaryngol,2008,72:1643-1650.
[12] BERÇIN S,KUTLUHAN A,CETIN H,et al.Relation-ship between adenoid vegetation and anatomic variationsof paranasal sinuses[J].Acta Otolaryngol,2008,128:1116-1119.
[13] 王涛,杨钦泰,李鹏,等.儿童慢性鼻-鼻窦炎不同治疗方式的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2010,24(11):489-491.
[14] 周本忠,王胜国,李龙巧,等.儿童慢性鼻-鼻窦炎的药物治疗与手术治疗临床疗效观察[J].临床耳鼻咽喉头颈外科杂志,2011,25(5):213-216.
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