中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
10期
773-776
,共4页
卢君%江远仕%林广裕%周晓华%蔡晓莹%黄素红%林创兴%陈派镇%谢金纯
盧君%江遠仕%林廣裕%週曉華%蔡曉瑩%黃素紅%林創興%陳派鎮%謝金純
로군%강원사%림엄유%주효화%채효형%황소홍%림창흥%진파진%사금순
鼻窦炎,慢性%治疗%真实世界研究%儿童
鼻竇炎,慢性%治療%真實世界研究%兒童
비두염,만성%치료%진실세계연구%인동
Sinusitis,chronic%Treatment%Real world research%Child
目的 探讨《欧洲鼻窦炎和鼻息肉指南2007版》(《EPOS 2007》)中关于儿童慢性鼻-鼻窦炎(CRS)治疗建议的临床应用.方法 采用多中心前瞻性病例自身前后对照研究方法,选取临床和CT确诊为CRS忠儿60例,全部应用小剂量阿奇霉素和孟鲁司特钠12周以上,19例延长阿奇霉素或/和孟鲁司特钠疗程,其中9例加用短程(5 ～7 d)头孢克洛,3例加用鼻用糖皮质激素.治疗12周后,应用视觉模拟量表(VAS)主观评价和Lund-Mackay CT评分法进行客观评价.结果 60例患儿应用阿奇霉素和孟鲁司特钠12周后,VAS评分由7.92±2.66降至2.13±1.11,差异有统计学意义(t=4.01,P=0.001);Lund-Mackay CT评分由14.12±3.30降至2.53±1.71,差异有统计学意义(t=2.83,P=0.005).其中41例12周后完全停药,至今随访(18.12±6.25)个月,末见CRS复发症状;余19例分别有延长阿奇霉素或/和孟鲁司特钠疗程,其中9例加用短程头孢克洛、3例加用鼻用皮质激素等,总疗程延长至24周后均能停药,从停药随访至今(6.23 ±2.13)个月,末见CRS复发症状.结论 根据《EPOS 2007》,对儿章CRS应用小剂量阿奇霉素和孟鲁司特钠治疗3个月可获显著疗效.
目的 探討《歐洲鼻竇炎和鼻息肉指南2007版》(《EPOS 2007》)中關于兒童慢性鼻-鼻竇炎(CRS)治療建議的臨床應用.方法 採用多中心前瞻性病例自身前後對照研究方法,選取臨床和CT確診為CRS忠兒60例,全部應用小劑量阿奇黴素和孟魯司特鈉12週以上,19例延長阿奇黴素或/和孟魯司特鈉療程,其中9例加用短程(5 ～7 d)頭孢剋洛,3例加用鼻用糖皮質激素.治療12週後,應用視覺模擬量錶(VAS)主觀評價和Lund-Mackay CT評分法進行客觀評價.結果 60例患兒應用阿奇黴素和孟魯司特鈉12週後,VAS評分由7.92±2.66降至2.13±1.11,差異有統計學意義(t=4.01,P=0.001);Lund-Mackay CT評分由14.12±3.30降至2.53±1.71,差異有統計學意義(t=2.83,P=0.005).其中41例12週後完全停藥,至今隨訪(18.12±6.25)箇月,末見CRS複髮癥狀;餘19例分彆有延長阿奇黴素或/和孟魯司特鈉療程,其中9例加用短程頭孢剋洛、3例加用鼻用皮質激素等,總療程延長至24週後均能停藥,從停藥隨訪至今(6.23 ±2.13)箇月,末見CRS複髮癥狀.結論 根據《EPOS 2007》,對兒章CRS應用小劑量阿奇黴素和孟魯司特鈉治療3箇月可穫顯著療效.
목적 탐토《구주비두염화비식육지남2007판》(《EPOS 2007》)중관우인동만성비-비두염(CRS)치료건의적림상응용.방법 채용다중심전첨성병례자신전후대조연구방법,선취림상화CT학진위CRS충인60례,전부응용소제량아기매소화맹로사특납12주이상,19례연장아기매소혹/화맹로사특납료정,기중9례가용단정(5 ～7 d)두포극락,3례가용비용당피질격소.치료12주후,응용시각모의량표(VAS)주관평개화Lund-Mackay CT평분법진행객관평개.결과 60례환인응용아기매소화맹로사특납12주후,VAS평분유7.92±2.66강지2.13±1.11,차이유통계학의의(t=4.01,P=0.001);Lund-Mackay CT평분유14.12±3.30강지2.53±1.71,차이유통계학의의(t=2.83,P=0.005).기중41례12주후완전정약,지금수방(18.12±6.25)개월,말견CRS복발증상;여19례분별유연장아기매소혹/화맹로사특납료정,기중9례가용단정두포극락、3례가용비용피질격소등,총료정연장지24주후균능정약,종정약수방지금(6.23 ±2.13)개월,말견CRS복발증상.결론 근거《EPOS 2007》,대인장CRS응용소제량아기매소화맹로사특납치료3개월가획현저료효.
Objective To explore the clinical application of treatment on childhood patient with chronic sinusitis (CRS) based on"European Position Paper on rhinosinusitis and nasal polyps 2007" (EPOS 2007) under the background of real world research.Methods A multi-center prospective crossover study was performed,and 60 cases of CRS diagnosed base on clinical features and CT imaging who were applied of small doses of azithromycin and montelukast for 12 weeks or more were selected.Nineteen cases prolonged azithromycin and/or montelukast treatment,and 9 cases of them were added a short course (5-7 days) of cefaclor and 3 cases of them added loratadine and nasal corticosteroids.Visual analog scale (VAS) was used for subjective evaluation and Lund-Mackay CT was used for objective evaluation after 12 weeks of treatment.Results After 12 weeks of treatment,the average VAS score was decreased from (7.92 ± 2.66) to (2.13 ± 1.11),and there was a significant difference (t =4.01,P =0.001) ; Lund-Mackay CT score was decreased from (14.12 ± 3.30) to (2.53 ± 1.71),and there was significant difference (t =2.83,P =0.005).Forty-one cases were followed up for (18.12 ± 6.25)months after 12 weeks treatment,and the drug withdrawal showed no recurrence of CRS symptoms.The other 19 cases were received with azithromycin and/or montelukast treatmem longer or combined with a short course of cefaclor,or nasal corticosteroids respectively,and were followed up for (6.23 ± 2.13) months after extend to 24 weeks of total course could withdrawal,and there was no recurrence of CRS symptoms after drug withdrawal.Conclusions There is a significant effect after application of azithromycin and montelukast on treatrment of CRS base on EPOS 2007.
