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目的探讨如何提高对小儿副鼻窦支气管炎的认识,减少漏诊和误诊,提高治愈率。方法57例经CT确诊小儿副鼻窦支气管炎的患儿,选用阿莫西林/克拉维酸、第2或第3代头孢类、喹诺酮类、奥硝唑等联合交替使用,治疗急性发作,并配合上颌窦冲洗,缓解期采用小剂量阿奇霉素、祛痰剂口服和定期肌内注射丙种球蛋白,总疗程约3个月,疗程结束后复查CT并判定疗效。结果57例患儿中,24例坚持治疗3个月以上者全部治愈(100%);19例总疗程小于3个月者,5例痊愈(26.3%),14例显效(73.3%);14例未按要求治疗者无1例痊愈。结论若儿童出现不明原因慢性咳嗽,反复鼻塞、流涕、头痛,应考虑到小儿副鼻窦支气管炎的可能,及时行CT检查以明确诊断,并采用抗炎、祛痰、免疫调节配合上颌窦冲洗的治疗方案,抗炎强度要大,疗程以3个月左右为佳。
Objective To explore how to improve the cognition of pediatric sinusitis, reduce the misdiagnosis and misdiagnosis, and improve the cure rate. Methods Fifty-seven children with infantile sinusitis were diagnosed by CT. The patients were treated with combination of amoxicillin / clavulanic acid, second or third generation cephalosporins, quinolones, ornidazole, etc. to treat acute attack and to cooperate with Maxillary sinus irrigation, remission of small doses of azithromycin, expectorant oral and regular intramuscular injection of gamma globulin, the total course of about 3 months after the end of the review of the CT and determine the efficacy. Results Of the 57 cases, 24 cases were cured completely (100%) for more than 3 months; 19 cases were less than 3 months, 5 cases were cured (26.3%), 14 cases were markedly effective (73.3%), 14 Cases did not receive the required treatment without recovery in 1 case. Conclusion Children with chronic cough of unknown origin, repeated nasal obstruction, runny nose and headache should take into account the possibility of infantile sinus pain and timely CT examination to confirm the diagnosis and use of anti-inflammatory, expectorant, immunomodulatory and maxillary sinus rinse The treatment program, anti-inflammatory strength should be large, treatment to 3 months or so better.