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yxfbbiedtj · Wysłany: Wto 13:38, 22 Mar 2011

86 cases of children with chronic maxillary sinusitis and treatment of clinical symptoms

Purulent nasal discharge flow 45, 28 headache, memory loss, 9,[link widoczny dla zalogowanych], 13, snoring breath, swelling of the inferior turbinate 29, nasal empyema 43, adenoid hypertrophy l1, swollen tonsils 18. Control group; nose Saiga, purulent nasal discharge flow 38, 21 headache, memory loss, 6, 9, snoring breath,[link widoczny dla zalogowanych], swelling of the inferior turbinate 27, nasal empyema 37, the proliferation of permanent hypertrophy 12, 14 swollen tonsils. 1.3 sinus CT scan cr showed bilateral maxillary or high density fluid level by the treatment group 33, control group 24. Unilateral maxillary sinus fluid level or density were increased, the treatment group 13, control group 16. Those with sinus inflammation, the treatment group 13, control group 8. Coronal CT scan, of which funnel the treatment group 23, control group 16. I = 1 nasal sinus complex shape by treatment group 9, the control group 7. Axial scan, I = 1 complete sinus occlusion group 7, control group 11. In parts of the maxillary sinus were inflated, the treatment group 7, control group 6.2 2.1 treatment group all treatment of maxillary sinus puncture line, out of sinus pus, with 0.5% metronidazole rinse sinuses, through core needle catheter (spinal anesthesia with a silicone tube) fixed on the cheek, sinus drip daily to metronidazole 250Ird, 0.9% sodium chloride 2.50 ~ 5COml (Trappe tangled within the Ka-hing, elk protease, dexamethasone, etc.), until the disappearance of purulent nasal discharge, usually 5-7 days to heal. Meanwhile, recurrent tonsillitis, adenoid hypertrophy, surgical removal of a total of 19 cases, accounting for 413%. After the above treatment, one-time cure (ventilation smooth, non-purulent nasal discharge, symptoms disappeared and normal sinus concave or film) 41 cases, accounting for 89.1%; treatment improved (ventilation Chang, purulent nasal discharge reduction,[link widoczny dla zalogowanych], cr, or film there is still a small amount of mucosal thickening) in 5 cases,[link widoczny dla zalogowanych], 10.9%; invalid (no). 2.2 The control group did not agree to the foregoing treatment, given nasal drops nasal drip furosemide Ma, improve drainage, I = 1 serving or intravenous antibiotics tangled, sinusitis, I = 1 服 solution, in part by tonsillectomy. After the treatment, one cured in 6 cases. 15%; treatment of 4 cases improved, 10%; invalid in 23 cases, 57.5%. Some children mobilization tube line treatment, 7 patients lost. After the two groups were followed up for 0.5-2 years. 3 Discussion of 3.1 to two sick no significant difference in the incidence of gender, the majority of 9 to 11 years old, onset time was more than 1-3 years, two German high incidence of clinical symptoms in a single German nasal obstruction, purulent nasal discharge flow, the main headache. Clinical examination the following turbinate swelling, nasal empyema as the most common of all cases without nasal polyps in children as young children, treatment, lack of cooperation, and should not be taken to surgery. Antibiotic therapy was not obvious, intranasal drug into the sinuses in general is difficult, and no results. We believe that, to the international accumulation of pus within the sinus to improve the treatment of sinus ventilation and drainage are the key to the maxillary sinus puncture lavage therapy to teach and reliability of the exclusion of nasal pus and physiological function recovery of children with non-invasive. Cytological studies of sinusitis in recent years, suggesting that most of the anaerobic and aerobic mixed infections, and metronidazole against anaerobic bacteria was stronger, and improve the efficacy of gentamicin and other collaboration. Because local administration of sinuses and found no adverse drug reactions. CT features of 3.2 children,[link widoczny dla zalogowanych], sinus small sinuses, sinus disease over the main award, a few involving the ethmoid sinus. Frontal sinus, sphenoid sinus, some undeveloped, even if well-developed, is also found inflammatory changes. Sinus due to thick pus on the award, so the liquid surface was flat at times, but mistaken for mucosal hypertrophy, adjust the value of the window can help identify conditions and concave. Scan shows sinus concave crown I = 1 nasal sinus complex to be accurate, in addition to clearly show the lesion outside, and can be awarded to the sinus catheterization provide the basis for positioning. 3.3 Treatment of maxillary sinus puncture in children must be familiar with the local anatomy, the nasal cavity can be sprayed surface anesthesia of 2% tetracaine, dark puncture protection by parents to children to overcome fear. Flushing to let children alternating every 10 to 20 minutes 1 second blowing your nose, sinus to drain pus. 3.4 tonsillitis secondary to recurrent adenoid hypertrophy after infection or nasal obstruction, recurrent sinusitis lead to one of the main lesion removed tonsils, adenoids is the key to preventing the recurrence of sinusitis. Also conducive to improving nasal ventilation and restore physiological function of nasal cavity and sinuses. 4 Conclusion children with chronic maxillary sinusitis harm children's health, affect children's learning and life. Au for the diagnosis of a clear image of maxillary sinus puncture is safe and effective irrigation, the use of drugs can effectively control bacterial infection, reduce the mucosal edema, improve sinus ventilation and restore sinus physiological functions, local application of toxic side effects. Removal of tonsils and adenoids disease, can be saved to prevent the occurrence of sinusitis. (20OO-03-O7 Received 2OO0-O6-15 Revised) [Lvpei Bin braided hair]