【摘要】 目的探讨不伴有变应性鼻炎小儿鼾症序列治疗后复发原因及再治疗的有效方法。方法病例为2015年1月～2017年10月我院门诊序列治疗后复发的35例不伴有变应性鼻炎小儿鼾症患者。所有病例在序列治疗的基础上,加用左氧氟沙星滴眼液加布地奈德混悬液滴鼻2周。治疗2周后进行评估,评估方法根据Bitar MA的家长问卷获得,不论有效与否停用滴鼻治疗,继续使用左西替利嗪、孟鲁司特钠以及维生素D钙咀嚼片治疗,2周再评估,若无效,再考虑行手术治疗。结果同期治疗不伴有变应性鼻炎小儿鼾症1355例,随访1年以评估远期疗效,35例在序列治疗后不同时间复发,复发时间为3个月～1年,复发率为2.583%(35/1355),复发原因主要是上呼吸道感染和营养不良,其中有上呼吸道感染史35例,占100%(35/35);营养不良30例,占85.00%(30/35)。治疗2周后,总有效率?80.00%(28/35);治疗4周后,总有效率?91.40%(32/35);本组病例有3例行腺样体伴扁桃体切除术,手术后痊愈。结论不伴有变应性鼻炎小儿鼾症序列治疗的近期和远期疗效皆显著,值得临床推广;治疗后复发的病例可以进行再治疗,效果不佳时再考虑手术治疗。更多还原

【Abstract】 Objective To explore the effective method of recurrence and retreatment after sequence therapy of pediatric obstructive sleep apnea children without allergic rhinitis. Method 35 recurrent patients without allergic rhinitis who have undergone sequential treatment from January 2015 to October 2017 in our hospital. All cases were treated with nasal drops combined by Levofloxacin eye drops and Budesonide suspension on the basis of sequence therapy for 2 weeks. After 2 weeks of treatment, the assessment was performed. The assessment method was based on Bitar MA’s Parental Questionnaire. Discontinuation of nose drops,continue to use levocetirizine, montelukast sodium chewable tablets and vitamin D calcium chewable tablets for treatment for 2 weeks.If invalid after the retreatment, surgical treatment is considered. Result We used sequential therapy to treat 1355 cases of pediatric obstructive sleep apnea children without allergic rhinitis.They were followed up for 1 year to assess long-term efficacy and 35 cases recurred at different times. The recurrence time was 3 months to 1 year, and the recurrence rate was 2.583%(35/1355). The main causes of recurrence were upper respiratory tract infections and malnutrition, including 35 cases of upper respiratory tract infections,accounting for 100%(35/35); 30 cases of malnutrition, accounting for 85.00%(30/35). After 2 weeks of treatment, the total effective rate was 80.00%(28/35); after 4 weeks of treatment, the total effective rate was 91.40%(32/35). 3 invalid cases underwent adenotonsillectomy in this group of patients and postoperative recovery is quiet good. Conclusion The short-term and long-term curative effects of the sequence therapy of pediatric obstructive sleep apnea children without allergic rhinitis are significant and worthy of clinical promotion.Cases of recurrence after treatment can be retreated, and surgery is considered when the effect is not good.更多还原