山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 101-104.doi: 10.6040/j.issn.1673-3770.0.2020.243

• 论著 • 上一篇    下一篇

儿童鼻腔异物与过敏性鼻炎关系的初步研究

林兴,沈翎,林宗通,杨中婕   

  1. 林兴, 沈翎, 林宗通, 杨中婕福建省福州儿童医院/福建医科大学附属福州儿童医院 耳鼻咽喉科, 福建 福州 350005
  • 收稿日期:2020-05-27 出版日期:2020-07-20 发布日期:2020-08-28

Relationship between nasal foreign body and allergic rhinitis in children: a preliminary studyLIN Xing, SHEN Ling, LIN Zongtong, YANG Zhongjie Department of Otorhinolaryngology, Fuzhou Children's Hospital of Fujian Province/Fuzhou Children's Hospital of Fujian Medical University, Fuzhou 350005, Fujian, ChinaAbstract: Objective〓

To investigate the relationship between nasal foreign bodies and allergic rhinitis in children. MethodsThis single-center study retrospectively evaluated the clinical data, treatment methods used, and complications reported for 161 pediatric patients with nasal foreign bodies who were treated between January 2017 and June 2018. ResultsA total of 161 patients were reviewed(91 boys and 70 girls). Among them, the age of high hair was 3-5 years old, and accounted for 81.4% of all the patients. Of these, 137(85.1%)children had nasal itching, rubbing nose, nose-picking, sneezing, epistaxis, nasal congestion, nasal hemorrhage, and other symptoms; 112 cases(69.6%)tested positive for sIgE(specific Immunoglobulin E)and were diagnosed with allergic rhinitis. The prevalence of allergic rhinitis in children with nasal foreign bodies was 69.6%, significantly higher than that reported for the general population(7.83%-20.42%; P<0.001). ConclusionIn children, nasal foreign bodies are closely associated with allergic rhinitis. Children with nasal foreign bodies should be particularly monitored for the development of allergic rhinitis. When allergic rhinitis is suspected, it should be promptly diagnosed and optimal treatment should be administered.   

  1. Key words: Nasal foreign bodies;
    SIgE;
    Allergic rhinitis;
    Children儿童鼻腔异物是耳鼻咽喉科门急诊中的常见病之一, 多因儿童玩耍时自己将豆类、玩具等塞入鼻腔又难以自行取出或事后忘记造成的[1]。既往多认为此类患儿因好奇心所致[2]。然而, 在诊疗中大部分鼻腔异物患儿伴有鼻痒、鼻不适感等鼻部症状, 推测鼻腔异物患儿可能将异物塞入鼻腔以缓解鼻部不适。而鼻腔异物与过敏性鼻炎的关系目前国内外均无相关研究, 为探讨儿童鼻腔异物与过敏性鼻炎的关系, 我们收集并分析了2017年1月~2018年6月在我科诊治、资料完整的鼻腔异物161例患儿的临床资料, 现总结报道如下。
  • Received:2020-05-27 Online:2020-07-20 Published:2020-08-28

摘要: 目的 探讨儿童鼻腔异物与过敏性鼻炎的关系。 方法 选择资料完整的161例鼻腔异物患儿的临床资料进行回顾性分析。 结果 161例鼻腔异物患儿中,3~5岁为高发人群,占81.4%。137例(85.1%)患儿平时有鼻痒、打喷嚏、流清涕等鼻部症状,其中112例(69.6%)特异性IgE检测阳性,并确诊为过敏性鼻炎。鼻腔异物患儿中过敏性鼻炎的患病率为69.6%,明显高于普通人群的7.83%和20.42%,差异有统计学意义(P<0.001)。 结论 鼻腔异物与过敏性鼻炎关系密切。对鼻腔异物的患儿,应关注是否有过敏性鼻炎,并予以规范化诊疗。

关键词: 鼻腔异物, 特异性IgE, 过敏性鼻炎, 儿童

Abstract: Objective To investigate the relationship between nasal foreign bodies and allergic rhinitis in children. Methods This single-center study retrospectively evaluated the clinical data, treatment methods used, and complications reported for 161 pediatric patients with nasal foreign bodies who were treated between January 2017 and June 2018. Results A total of 161 patients were reviewed(91 boys and 70 girls). Among them, the age of high hair was 3-5 years old, and accounted for 81.4% of all the patients. Of these, 137(85.1%)children had nasal itching, rubbing nose, nose-picking, sneezing, epistaxis, nasal congestion, nasal hemorrhage, and other symptoms; 112 cases(69.6%)tested positive for sIgE(specific Immunoglobulin E)and were diagnosed with allergic rhinitis. The prevalence of allergic rhinitis in children with nasal foreign bodies was 69.6%, significantly higher than that reported for the general population(7.83%-20.42%; P<0.001). Conclusion In children, nasal foreign bodies are closely associated with allergic rhinitis. Children with nasal foreign bodies should be particularly monitored for the development of allergic rhinitis. When allergic rhinitis is suspected, it should be promptly diagnosed and optimal treatment should be administered.

Key words: Nasal foreign bodies, SIgE, Allergic rhinitis, Children

中图分类号: 

  • R765.2
[1] 孔维佳,周梁. 耳鼻咽喉头颈外科学[M]. 3版. 北京: 人民卫生出版社, 2015.
[2] 黄世凡, 邓云, 舒建满, 等. 117例儿童鼻腔异物的临床诊治[J]. 中国耳鼻咽喉颅底外科杂志, 2014, 20(2): 155-157. doi: 1007-1520.201402019. HUANG Shifan, DENG Yun, SHU Jianman, et al. Clinical management of nasal foreign body in 117 children[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2014, 20(2): 155-157. doi: 1007-1520.201402019.
[3] 中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会. 儿童过敏性鼻炎诊疗——临床实践指南[J]. 中国实用儿科杂志, 2019, 34(3):169-175.
[4] 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(1): 6-24.
[5] Zhao J, Bai J, Shen KL, et al. Self-reported prevalence of childhood allergic diseases in three cities of China: a multicenter study[J]. BMC Public Health, 2010, 10: 551. doi:10.1186/1471-2458-10-551.
[6] Awad A, ElTaher M. ENT foreign bodies: an experience[J]. Int Arch Otorhinolaryngol, 2018, 22(2): 146-151. doi:10.1055/s-0037-1603922.
[7] Endican S, Garap JP, Dubey SP. Ear, nose and throat foreign bodies in Melanesian children: an analysis of 1037 cases[J]. Int J Pediatr Otorhinolaryngol, 2006, 70(9): 1539-1545. doi:10.1016/j.ijporl.2006.03.018.
[8] Abou-Elfadl M, Horra A, Abada RL, et al. Nasal foreign bodies: Results of a study of 260 cases[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2015, 132(6): 343-346. doi:10.1016/j.anorl.2015.08.006.
[9] Bellocchi G, Acquaviva G, Giammona Indaco F, et al. Foreign bodies in the pediatric age: the experience of an Italian tertiary care hospital[J]. Acta Biomed, 2020, 91(1-S): 60-64. doi:10.23750/abm.v91i1-S.9260.
[10] Svider PF, Sheyn A, Folbe E, et al. How did that get there? A population-based analysis of nasal foreign bodies[J]. Int Forum Allergy Rhinol, 2014, 4(11): 944-949. doi:10.1002/alr.21396.
[11] Regonne PE, Ndiaye M, Sy A, et al. Nasal foreign bodies in children in a pediatric hospital in Senegal: a three-year assessment[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2017, 134(5): 361-364. doi:10.1016/j.anorl.2017.02.013.
[12] Baranowski K S V. Foreign Body, Nose[J]. [Updated 2019 Dec 20]. In: StatPearls [Internet]. Treasure Island(FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK-459279/.
[13] Hira(·overI), Tofar M, Bayram A, et al. Childhood nasal foreign bodies: analysis of 1724 cases[J]. Turk Arch Otorhinolaryngol, 2019, 57(4): 187-190. doi:10.5152/tao.2019.4096.
[14] Lou ZC. Analysis of nasal foreign bodies in 341 children[J]. J Laryngol Otol, 2019,16: 1-5. doi:10.1017/S0022215119001944.
[15] Cetinkaya EA, Arslan(·overI)B, Cukurova(·overI). Nasal foreign bodies in children: Types, locations, complications and removal[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(11): 1881-1885. doi:10.1016/j.ijporl.2015.08.036.
[16] Dann L, Doody J, Howard R, et al. Nasal foreign bodies in the paediatric emergency department[J]. Ir J Med Sci, 2019, 188(4): 1401-1405. doi:10.1007/s11845-019-02000-z.
[17] Huang T, Li WQ, Xia ZF, et al. Characteristics and outcome of impacted button batteries among young children less than 7 years of age in China: a retrospective analysis of 116 cases[J]. World J Pediatr, 2018, 14(6): 570-575. doi:10.1007/s12519-018-0188-9.
[18] 敬尚林, 林楠, 莫炼, 等. 纽扣式电池鼻腔异物6例临床分析[J].山东大学耳鼻喉眼学报, 2015(3):48-50. doi: 10.6040/j.issn.1673-3770.0.2014.329. JING Shanglin, LIN Nan, MO Lian, et al. Complications and treatment of nasal foreign body of button battery in 6 cases[J] , Journal of Otolaryngology and Ophthalmology of Shandong University, 2015(3):48-50. doi: 10.6040/j.issn.1673-3770.0.2014.329.
[19] Bakhshaee M, Hebrani P, Shams M, et al. Psychological status in children with ear and nose foreign body insertion[J]. Int J Pediatr Otorhinolaryngol, 2017, 92: 103-107. doi:10.1016/j.ijporl.2016.11.003.
[20] Schuldt T, Großmann W, Weiss NM, et al. Aural and nasal foreign bodies in children - Epidemiology and correlation with hyperkinetic disorders, developmental disorders and congenital malformations[J]. Int J Pediatr Otorhinolaryngol, 2019, 118: 165-169. doi:10.1016/j.ijporl.2019.01.006.
[21] 沈翎, 杨中婕, 林宗通, 等. 《儿童过敏性鼻炎诊疗——临床实践指南》诊断部分解读[J]. 中国实用儿科杂志, 2019, 34(3): 25-28. doi: CNKI:SUN:ZSEK.0.2019-03-007. SHEN Ling, YANG Zhongjie, LIN Zongtong, et al. Interpretation of the diagnostic part of clinical practice guideline: diagnosis and treatment in children with allergic rhinitis[J]. Chinese Journal of Practical Pediatrics, 2019, 34(3): 25-28. doi: CNKI:SUN:ZSEK.0.2019-03-007.
[1] 吕静荣,陈淳,马衍,谢晋. 儿童分化型甲状腺癌的临床特征及危险因素分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 88-94.
[2] 徐海侠,崔晓波,刘佳荣,李欣,刘佳宜,刘晓玲. 内蒙古呼和浩特城区气传致敏花粉流行情况调查[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 106-109.
[3] 李勇. 儿童鼻窦炎的诊治——困难、挑战与对策[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 1-7.
[4] 许庚. 儿童慢性鼻窦炎的常规诊断不宜使用CT扫描[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 8-9.
[5] 杨一帆, 程雷. 儿童鼻窦炎与哮喘:统一气道疾病[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 10-15.
[6] 李华斌, 曹玉洁. 儿童鼻窦炎的临床诊疗进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 16-19.
[7] 李勇. 抗生素在儿童鼻窦炎治疗中的地位[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 20-24.
[8] 张立强. 儿童鼻窦炎与腺样体肥大的关系[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 25-28.
[9] 刘佳, 付勇. 儿童慢性鼻窦炎的外科治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 29-33.
[10] 张婵媛, 孙玉霖, 王琳, 张莉, 陈敏, 于龙刚, 李娜, 崔鑫, 姜彦. 儿童鼻窦炎眶并发症诊治31例及文献分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 34-40.
[11] 朱鲁平, 陈娟, 朱垒, 陈仁杰. 儿童急性鼻窦炎合并肾小球肾炎及眶内脓肿一例[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 41-44.
[12] 陈蔚华,张凯扬,郑晓彬. 小儿喉、气管、支气管异物221例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 111-115.
[13] 吴兆坤,朱新华. 腺样体扁桃体切除术治愈儿童阻塞性睡眠呼吸暂停综合征的偏误研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 148-152.
[14] 倪菁,雷飞,白丹,周韵,马建梅,黄伟,王春阳. 儿童分泌性中耳炎耳积液中免疫相关指标表达分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 56-59.
[15] 赵海涛,石磊,王俊霞,王亚芳. 儿童危重气管支气管异物的气道管理及麻醉体会[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 96-98.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!