小儿鼻后滴漏并发慢性咳嗽66例临床分析

目的探讨以慢性咳嗽为主要表现的小儿鼻后滴漏的病因诊断和治疗方案。方法回顾性分析2001年1月至2005年6月本院收治的66例以鼻后滴漏为主要临床特点而并发慢性咳嗽的鼻-鼻窦疾病患儿的诊治过程。结果本组患儿中慢性化脓性鼻窦炎32例(48.5%,其中并发鼻息肉5例),慢性鼻炎22例(33.3%),变应性鼻炎9例(13.6%),急性腺样体炎3例(4.6%)。均以慢性咳嗽为主诉,平均咳嗽时间达8个月。经过积极的抗炎与抗变态反应治疗以及必要的手术治疗,57例(86.4%)咳嗽症状消失,9例(13.6%)症状明显减轻。所有患儿随访0.5￣2年,共有3例患儿症状复发(4.5%)。结论以鼻后滴漏为主要临床特点的鼻-鼻窦疾病可以并发慢性咳嗽,且可以此症状为主要临床特点,而不表现出典型、明确的鼻-鼻窦疾病症状。积极治疗鼻-鼻窦疾病,可以有效地消除继发性咳嗽症状。

Clinical Analysis on 66 Children Cases With Chronic Cough Complicated From Postnasal Drip Leakage

Objective To explore effective diagnosis and therapeutic strategy for nasosinopathy, postnasal drip leakage as main manifdstion of the disease, Usually, it complicated with chronic cough among the sick children' cases. Methods A retrospective study was carried out among 66 cases of postnasal drip leakage, as its main clinical feature, at the same time they complicatied with chronic cough.All cases were treated in ours hospital from Jan, 2000 to Jun, 2005. Careful analysis on their clinical data was made in order to find out the clinical features for this kind of condition and to summarize the experience of diagnosis and treatment for this lesion. Results All the cases were seen with chronic cough as their main complaining, with an averaged cough period lasted for 8 months, but no obvious lesion was found in their throat, trachea and branches, lung and stomach. However, definite lesions were determined in nasal cavity and/or paranasal sinuses, including chronic suppurative sinusitis in 32 cases (48.5%, with 5 complicating nasal polyps), chronic rhinitis in 22 (33.3%), nasal allergy in 9 (13.6%), and acute adenoiditis in 3 (4.6%). Following effective anti-inflammatory and/or anti-allergic therapies supplemented with necessary surgical procedures,chronic cough symptom of 57 cases (86.4%)was disappeared and 9 (13.6%) significantly alleviate. However, there were 3 cases reoccurred lesion during the following up period lasted 0.5 to 2 years. Conclusions postnasal drip leakage as main manifestation of rhinosinusopathia, it can complicate chronic cough, also may be clinically feature this kind of secondary pulmonary symptom without typical and definite symptoms of primary lesion in nasal cavity and/or sinuses, especially among children cases. This kind of secondary pulmonary symptom can be cured among most cases following effective treatment.