摘要
【目的】采用随机对照方法研究药物治疗及手术干预在腺样体肥大治疗中的效果和作用,以期为腺样体肥大规范治疗提供依据。【方法】将门诊符合研究入组原则和标准的儿童腺样体肥大患者83例(病史>12周)按照随机原则分为单纯药物治疗组或者手术干预治疗组,治疗3月后,通过对腺样体大小改变、免疫球蛋白水平的改变、分泌性中耳炎的疗效评价、儿童慢性鼻窦炎的疗效评价、儿童阻塞性睡眠呼吸暂停低通气综合征的疗效评价,采用单样本t检验及两组独立样本t检验、有序分类资料的秩和检验等统计学方法,比较两组患儿的治疗效果。【结果】治疗前两组患儿的腺样体大小无统计学差异,治疗后两组腺样体大小有统计学差异(P=0.038),两组患儿治疗后的腺样体大小分别同治疗前比较有统计学差异(P=0.000。两组治疗前及治疗后3月血清中IgA、IgG、IgM变化经t检验统计学比较均无差异(P>0.05)。两组分泌性中耳炎、儿童慢性鼻窦炎、儿童阻塞性睡眠呼吸暂停低通气综合征疗效对比无统计学差异(P值分别为0.822、0.773、0.559)。【结论】腺样体肥大通过规范的单纯药物治疗能够达到良好的治疗效果,治疗后3个月的疗效观察发现手术干预措施并不会增加此类患儿的治疗效果,因此,腺样体肥大患儿的治疗应首选规范的药物治疗,手术治疗的指征应更加严格。
[Objective] To compare the effects of pharmacotherapy and surgical intervention in the treatment of adenoid hypertrophy and to make evidence base for standard pharmacotherapy. [Methods] 83 outpatient children cases with adenoid hypertrophy were randomly divided into two groups （case history 〉12 weeks）： pure pharmacotherapy group （PP group） and surgical intervention group （SP group）. Clinical therapeutic effect evaluation was did on 3 months after treatment （pharmacotherapy or surgery ＋ pharmaeotherapy） including adenoid size, immunoglobulin levels, effect evaluation of secretory otitis media, children rhinosinusitis and children obstructive sleep apnea and hyponea syndrom. Single sample t-test/two groups of independent sample t test and KruskalWallis Test of orderly classified data were used to compare the clinical therapeutic effect of two groups. [ Results ] There was no statistical difference of adenoid size between the two groups before treatment, but there was statistical difference of adenoid size on 3 months after treatment between two groups（P=0.038）. Adenoid size after treatment was statistically different with it before treatment in each group （P=0.000）. IgA, IgG, and IgM levels before treatment were no statistically different with its after treatment of 3 months in each group （P〉0.05）. There were no statistic differences between two groups when effects of secretory otitis media, children rhinosinusitis, and children obstructive sleep apnea and hyponea syndrom were evaluated by Kruskal Wallis test （P=0.822, 0.773, 0.559）. [Conclusions] Pure standard pharmacotherapy could achieve good results. Effects evaluation after 3 months of treatment showed that surgical intervention did not increase therapeutic effect on adenoid hypertrophy. Children patients suffering from adenoid hypertrophy should be treated firstly by pharcotherapy, and surgical intervention should be more cautious and strict.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2012年第3期373-377,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
珠海市医学科研项目(2009)
