| 摘要: |
| [摘要] 目的:应用真实世界研究(
RWR)的方法,结合《欧洲鼻窦炎和鼻息肉指南 2012 版》,探讨应用孟鲁司特和小剂量阿奇霉素 治疗儿童慢性鼻窦炎(
CRS)的临床效果。 方法:采用多中心前瞻性病例自身前后对照的研究方法,对确诊为 CRS 的 138 例患儿, 应用孟鲁司特和小剂量阿奇霉素治疗
12 周以上,部分患儿加用短程抗生素、延长阿奇霉素和(或)孟鲁司特疗程,部分患儿加用鼻 用皮质激素。 疗程结束后,应用视觉模拟评分(
VAS) 进行主观评价和 Lund鄄Mackay CT 评分法进行客观评价。 结果:以 Lund鄄
Mackay CT 评分<2 分为停药指征,应用阿奇霉素和孟鲁司特治疗 12 周后,138 例患儿平均 VAS 评分及平均 Lund鄄Mackay CT 评分 均显著下降,其中
107 例患儿 12 周即完全停药;22 例 Lund鄄Mackay CT 评分 2 ~ 5 分者停用阿奇霉素,继续口服孟鲁司特,12 例加用 糠酸莫米松鼻喷雾剂
1-3 个月后停药;9 例 Lund鄄Mackay CT 评分>5 分者延长阿奇霉素和孟鲁司特疗程,或加用短程抗生素及鼻 用皮质激素等,总疗程延长至
24 周后停药。 138 例患儿均随访 1 年以上,除 2 例外,未见 CRS 复发症状。 结论:根据《欧洲鼻窦炎和鼻息肉指南2012 版》结合 RWR 方法的治疗原则,应用小剂量阿奇霉素和孟鲁司特治疗儿童 CRS 12 周,大部分患儿可获显著疗效。 |
| 关键词: 慢性鼻窦炎 儿童 真实世界研究 阿奇霉素 孟鲁司特 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.03.004 |
|
| 基金项目:汕头市科技计划项目,汕府科[2014]62 号。 |
|
| A Real World Research of Montelukast Combined with Small Doses of Azithromycin in the Treatment of Chronic Rhinosinusitis in Children |
| Xiao Zexi1, Zhang Xiaohong2, Lin Guangyu1, Lin Dongli3 |
| (1. The Second Affiliated Hospital of Shantou University Medical College
, Guangdong Shantou 515041, China; 2. The First Affiliated Hospital of Shantou University Medical College, Guangdong Shantou
515041, China; 3. Chenghai District People爷s Hospital of Shantou, Guangdong Shantou 515800, China) |
| Abstract: |
| [Abstract] Objective: To explore the clinical effect of montelukast and small dose of azithromycin in the treatment of children with
chronic rhinosinusitis (CRS) according to Real World Research (RWR) combined with European position paper on rhionsinusitis and
nasal polyps 2012 (EPOS 2012). Methods: A multicenter prospective self-contrast method was applied. One hundred and thirty-eight
children diagnosed as CRS were treated by montelukast and small doses of azithromycin more than 12 weeks. Some children were given
short course of antibiotics, prolonged azithromycin and / or montelukast were applied to treatment. A small number of nasal corticosteroids
were added. Visual analogue scale ( VAS) was used for subjective evaluation and Lund-Mackay CT scores was used for objective
evaluation after the treatment. Results: After 12 weeks of treatment, average VAS and Lund-Mackay CT scores of 138 cases showed
significant decreased. One hundred and nine cases were drug withdrawal after 12 weeks, while the other 9 cases (with Lund-Mackay CT
scores >5) were extended azithromycin and / or montelukast, or with short course of antibiotics and nasal corticosteroids, the total course
of treatment was extended to 24 weeks. All the 138 cases were followed up for more than 1 year, except 2 cases, the others were without
recurrence of CRS symptoms. Conclusion: Most children with CRS receive significant effect after application of small doses of
azithromycin and montelukast treatment for 12 weeks based on the (EPOS 2012) combine with RWR. |
| Key words: chronic rhinosinusitis children Real World Research azithromycin montelukast |
