儿童鼻窦炎的诊治——困难、挑战与对策

doi:10.6040/j.issn.1673-3770.1.2019.055

摘要/Abstract

摘要： 儿童鼻窦炎作为耳鼻咽喉科和儿科常见疾病,近十几年来发病率逐渐上升,但中国有关于儿童鼻窦炎的流行病学调查缺失。儿童鼻窦炎因为常伴有急性病毒性上呼吸道感染、腺样体肥大、变应性鼻炎等,其症状重叠,诊断容易混淆。鼻内镜检查是重要的诊断手段之一,鼻窦CT扫描往往与病情不相符,且对儿童来说放射量偏大,在儿童中需要慎用。在治疗方面与成人不同,但较少有高质量的循证医学证据可循,局部糖皮质激素、鼻腔喷雾逐渐成为治疗儿童鼻窦炎的一线治疗方法,但抗生素的副作用近年来争议较大。就以上儿童鼻窦炎的诊断和治疗方面的难点和面临挑战急需达到临床共识,寻找对策。

关键词: 儿童鼻窦炎, 诊治, 治疗

Abstract: Sinusitis in children is a common disease in pediatric otorhinolaryngology. The incidence of sinusitis has gradually increased over the last 10 years. However, there is a lack of epidemiological research that focusses on pediatric sinusitis in China. Pediatric sinusitis is often accompanied by an acute viral upper respiratory tract infection, adenoid hypertrophy, and allergic rhinitis. As symptoms overlap it can be challenging to diagnose pediatric sinusitis. Nasal endoscopy is an important diagnostic method that can be used. A computed tomography(CT)scan of the sinus can often be inconsistent. Additionally, as the radiation dose is high, it should be carefully used in children. Treatment of pediatric sinusitis is different from sinusitis in adults. Also, there is less high-quality evidence available. An intranasal steroid and nasal spray are the first-line treatment used for children with sinusitis. The role of antibiotics has become increasingly controversial over the last few years. The difficulties and challenges in diagnosing and treating pediatric sinusitis need to be addressed so that clinical consensus can be reached and countermeasures can be used.

Key words: Pediatric sinusitis, Diagnosis, Treatment

中图分类号:

R765.4

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.

LI Yong. The difficulties, challenges, and strategy for diagnosing and treating pediatric sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 1-7.

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