莫米松鼻喷雾剂对儿童慢性分泌性中耳炎的疗效观察

目的 观察莫米松鼻喷雾剂治疗儿童腺样体肥大和分泌性中耳炎的效果.方法 将62例腺样体肥大患儿随机分为试验组和对照组,其中试验组35例,伴分泌性中耳炎17例,接受莫米松鼻喷雾剂治疗;对照组27例,伴分泌性中耳炎14例,接受呋喃西林麻黄碱滴鼻治疗.疗程均为5周,所有患者均接受症状评估,耳镜、鼻内镜、声阻抗检查.结果 试验组分泌性中耳炎的治愈率为43.8%,明显高于对照组的18.5%（P＜0.01）;治疗后,试验组的腺样体和后鼻孔比例明显下降（P＜0.01）,对照组腺样体和后鼻孔比例未见明显变化（P=0.221）,两组差异有统计学意义（P＜0.01）.结论 鼻腔局部使用激素可以显著缩小腺样体体积,改善鼻通气,从而使一部分中耳炎和腺样体肥大患儿避免手术.（中国眼耳鼻喉科杂志,2010,10：300-302）

Topical nasal steroids for the treatment of children with otitis media with effusion

Objective To observe the effect of topical nasal steroids for the treatment of children with otitis media with effusion and adenoid hypertrophy. Methods A total of 62 children aged from 3 to 12 years were randomly divided into the study group and the control group. The study group （35 patients with adenoid hypertrophy, 17 of them with otitis media with effusion） received intranasal mometasonc furoate monohydrate 100 μg per day, and the control group （27 patients with adenoid hypertrophy, 14 of them with otitis media with effusion） received intranasal ephedrine hydro- chloride nasal drops. All patients were evaluated at 5 weeks pesttreatment. The assessment of each patient included history, a symptom questionnaire, a tympanogram, a pure tone andiogram if possible, and otoscopic and endoscopic examinations. Results Resolution of otitis media with effusion in the study group （43.8%） was significantly higher than that in the control group （18.5% , P 〈 0.01 ）. Patients in the study group showed a significant decrease in adenoid size according to the endoscopic evaluation （P 〈0.01 ） ,and there was no significant change in that of the control group（P =0.221 ）. The difference in the adenoid size between the two groups was obvious （ P 〈 0.0t ） Conclusions Nasal mometasone furoate monohydrate treatment could significantly reduce adenoid hypertrophy and eliminate obstructive symptoms. It might be a useful alternative to surgery, at least in the short term, for otitis media with effusion. （Chin J Ophthalmol and Otorhinolaryngo1,2010,10：300-302）