儿童慢性扁桃体炎是一种常见的上呼吸道慢性炎症性疾病,通常表现为扁桃体长期肿大、反复发作的炎症和伴随症状。其病因复杂,与反复急性扁桃体炎、免疫系统发育不完善、细菌或病毒感染等因素密切相关。临床症状包括咽喉不适、口臭、吞咽...儿童慢性扁桃体炎是一种常见的上呼吸道慢性炎症性疾病,通常表现为扁桃体长期肿大、反复发作的炎症和伴随症状。其病因复杂,与反复急性扁桃体炎、免疫系统发育不完善、细菌或病毒感染等因素密切相关。临床症状包括咽喉不适、口臭、吞咽困难、打鼾及睡眠呼吸暂停等,严重者可影响儿童的生长发育和生活质量。诊断基于病史、体征和实验室检查,治疗方法包括保守治疗和手术。本综述旨在系统梳理并分析近年来关于儿童慢性扁桃体炎(chronic tonsillitis, CTL)的研究进展,涵盖其流行病学特征、潜在的病因机制、临床表现的异质性、诊断的挑战与策略,以及目前推荐的治疗方法和预防措施的有效性,并探讨未来研究方向的可能性。Chronic tonsillitis in children is a common chronic inflammatory disease of the upper respiratory tract, usually characterized by prolonged enlargement of the tonsils, recurrent inflammation and accompanying symptoms. Its etiology is complex and closely related to factors such as recurrent acute tonsillitis, underdevelopment of the immune system, and bacterial or viral infections. Clinical symptoms include throat discomfort, bad breath, dysphagia, snoring and sleep apnea, which in severe cases can affect children’s growth and development and quality of life. Diagnosis is based on history, signs and laboratory tests, and treatment includes conservative treatment and surgery. The purpose of this review is to systematically review and analyze the research progress of chronic tonsillitis (CTL) in children in recent years, covering its epidemiological characteristics, potential etiological mechanisms, heterogeneity of clinical manifestations, diagnostic challenges and strategies, as well as the effectiveness of currently recommended treatments and preventive measures, and explore possibilities for future research directions.展开更多
文摘儿童慢性扁桃体炎是一种常见的上呼吸道慢性炎症性疾病,通常表现为扁桃体长期肿大、反复发作的炎症和伴随症状。其病因复杂,与反复急性扁桃体炎、免疫系统发育不完善、细菌或病毒感染等因素密切相关。临床症状包括咽喉不适、口臭、吞咽困难、打鼾及睡眠呼吸暂停等,严重者可影响儿童的生长发育和生活质量。诊断基于病史、体征和实验室检查,治疗方法包括保守治疗和手术。本综述旨在系统梳理并分析近年来关于儿童慢性扁桃体炎(chronic tonsillitis, CTL)的研究进展,涵盖其流行病学特征、潜在的病因机制、临床表现的异质性、诊断的挑战与策略,以及目前推荐的治疗方法和预防措施的有效性,并探讨未来研究方向的可能性。Chronic tonsillitis in children is a common chronic inflammatory disease of the upper respiratory tract, usually characterized by prolonged enlargement of the tonsils, recurrent inflammation and accompanying symptoms. Its etiology is complex and closely related to factors such as recurrent acute tonsillitis, underdevelopment of the immune system, and bacterial or viral infections. Clinical symptoms include throat discomfort, bad breath, dysphagia, snoring and sleep apnea, which in severe cases can affect children’s growth and development and quality of life. Diagnosis is based on history, signs and laboratory tests, and treatment includes conservative treatment and surgery. The purpose of this review is to systematically review and analyze the research progress of chronic tonsillitis (CTL) in children in recent years, covering its epidemiological characteristics, potential etiological mechanisms, heterogeneity of clinical manifestations, diagnostic challenges and strategies, as well as the effectiveness of currently recommended treatments and preventive measures, and explore possibilities for future research directions.
文摘目的 探讨儿童双侧先天性中耳胆脂瘤(bilateral congenital cholesteatoma, BCC)的临床特点及手术方式。方法 回顾性分析5例(10耳)BCC患儿的临床资料,分析其手术方式及疗效。结果 BCC手术清除胆脂瘤,均先行病变严重侧,术后3~6月再行对侧手术,术前0.5、1、2、4 kHz气导平均听阈为45.1±13.3 dB HL,骨导平均听阈为9.6±5.7 dB HL。其中Ⅰ期1耳,Ⅱ期1耳,Ⅲ期3耳,这5耳经外耳道耳内镜下手术;Ⅳ期5耳,其中2耳行完壁式乳突切开+鼓室成形术,3耳行开放式乳突切开+鼓室成形术。术后随访2年,术后听力均较术前提高;术后除1耳(10%)复发,重新行开放式乳突切开+鼓室成形术外,其余患儿均未出现并发症。术后患儿气导平均听阈18.3±4.5 dB HL,骨导平均听阈6.2±4.1 dB HL,手术前后差异有统计学意义(P<0.01)。结论 手术治疗是BCC的唯一治疗方式,手术可提高患儿听力;Ⅰ、Ⅱ、Ⅲ期胆脂瘤病变较局限,未累及乳突,可优先考虑经外耳道耳内镜下手术;而Ⅳ期病变较广泛,累及乳突,建议显微镜下行乳突切开+鼓室成形术。
