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目的探讨丙酸氟替卡松鼻喷剂治疗腺样体肥大的效果。方法选择40例经临床症状评分和电子鼻咽镜检查确诊为腺样体肥大的患儿,予丙酸氟替卡松鼻喷剂每日1次,治疗3个月,比较治疗前后患儿临床症状的变化情况;临床症状改善的患儿停药后随访6个月,再次与治疗后的临床症状改善情况进行比较。结果40例患儿治疗3个月后,临床症状评分(6.58±2.13)和腺样体占后鼻孔的百分比[(67.60±18.21)%]与用药前[9.07±2.68,(77.20±6.45)%]比较均有显著性差异(P=0.001),其中28例(28/40,70.0%)临床症状综合评分治疗后改善,随访6个月,16例(16/28,57.1%)临床症状评分与用药结束时相比无显著性差异,12例(12/28,42.9%)症状再次加重。对最终治疗有效的16例患儿和治疗无效的24例患儿的相关临床资料进行比较,两者治疗前在临床症状评分上无显著性差异(P=0.207),但腺样体体积缩小,有显著性差异(P=0.002)。结论应用鼻用激素可有效减少腺样体体积,缓解临床症状,但停药后会有一部分患儿症状复发,复发可能与腺样体体积大小相关。
Objective To investigate the effect of fluticasone propionate nasal spray on adenoid hypertrophy. Methods Forty children with adenoid hypertrophy diagnosed by clinical symptom score and electronic nasopharyngoscopy were selected and treated with fluticasone propionate nasal spray once a day for 3 months to compare the changes of clinical symptoms in children before and after treatment The children with improved clinical symptoms were followed up for 6 months after discontinuation of treatment and again compared with the clinical symptoms after treatment. Results The clinical symptom scores (6.58 ± 2.13) and the percentages of adenoids in the posterior nostrils [(67.60 ± 18.21)%] in 40 infants were significantly higher than those before treatment [9.07 ± 2.68 (77.20 ± 6.45)%] (P = 0.001). The comprehensive clinical symptom scores of 28 cases (28/40, 70.0%) were improved after treatment, and were followed up for 6 months. The scores of clinical symptoms in 16 cases (16/28, 57.1% No significant difference compared with the end of medication, 12 patients (12/28, 42.9%) symptoms aggravated again. There was no significant difference in the clinical symptom scores between the two groups (P = 0.207), but the adenoid volume was reduced, There was a significant difference (P = 0.002). Conclusions The application of nasal hormones can effectively reduce the volume of adenoid and alleviate the clinical symptoms. However, some children may relapse after stopping the drug. The relapse may be related to the volume of adenoid.