局部鼻腔类固醇治疗儿童腺样体肥大：一项系统综述和荟萃分析。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-10-01 DOI:10.1016/j.ijporl.2025.112580

Asher T. Ripp , Ethan M. Kallenberger , Shaun A. Nguyen , Isabella V. Schafer , Clarice S. Clemmens , David R. White

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引用次数: 0

摘要

目的：腺样体肥大（AH）是导致儿童鼻塞、睡眠呼吸障碍和阻塞性睡眠呼吸暂停的常见病理。有症状的AH通常通过手术治疗，并且研究了几种医学干预措施，结果各不相同。本研究的目的是提供鼻内皮质类固醇（INCS）治疗AH的综合荟萃分析。数据来源：Cochrane， SCOPUS, PubMed， CINAHL。评价方法：本研究按照系统评价和荟萃分析指南的首选报告项目进行。感兴趣的研究包括在存在对照组的情况下评估INCS对儿童腺样体肥大的影响。结果：共纳入16项研究，1156例患者。636例患者进行了INCS评估，520例患者作为对照。治疗后，与对照组相比，INCS组严重AH患者百分比的下降幅度更大(- 43.5% vs - 13.3%, [95% CI: 19.8- 39.7%]， p结论：INCS治疗儿童腺样体肥大及其相关后遗症有效。在AH的主观症状严重程度和生理测量方面均有改善，这表明INCS可能会减少选定患者的手术需求。

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Topical nasal steroids for adenoid hypertrophy in children: A systematic review and meta-analysis

Objective

Adenoid hypertrophy (AH) is a common pathology in children leading to nasal obstruction, sleep disordered breathing, and obstructive sleep apnea. Symptomatic AH is often treated surgically, and several medical interventions have been investigated with varying results. The objective of this study is to provide a comprehensive meta-analysis of the use of intranasal corticosteroids (INCS) for AH.

Data sources

Cochrane, SCOPUS, PubMed, CINAHL.

Review methods

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies of interest included those evaluating INCS for adenoid hypertrophy in children with the presence of a control group.

Results

A total of 16 studies comprising 1156 patients were included. INCS were evaluated in 636 patients, and 520 patients served as controls. The percentage of patients with severe AH in the INCS group saw a significantly greater decrease after treatment compared to the control group (−43.5 vs −13.3, [95 % CI: 19.8–39.7 %], p < 0.0001). The INCS group also experienced greater decreases in nasal obstruction (−1.6 vs −0.6) and nasal itching (−0.7 vs −0.2) compared to the control group (both p < 0.05). The rate of adenoidectomy following medical treatment was 22.3 % in the treatment group, compared to 98.6 % in the control group (76.2 % [95 % CI: 57.0–86.6 %] p < 0.0001).

Conclusion

INCS demonstrate efficacy in treating adenoid hypertrophy and its related sequelae in children. Improvements were noted in both subjective symptom severity and physiologic measurements of AH, indicating that INCS may reduce the need for surgery in selected patients.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.