基层医疗中心儿童的临床鼻窦炎

Clinical sinusitis in children attending primary care centers.

作者信息

Kakish K S, Mahafza T, Batieha A, Ekteish F, Daoud A

机构信息

Department of Pediatrics, Jordan University of Science and Technology, Irbid.

出版信息

Pediatr Infect Dis J. 2000 Nov;19(11):1071-4. doi: 10.1097/00006454-200011000-00008.

DOI:10.1097/00006454-200011000-00008

PMID:11099088

Abstract

OBJECTIVES

To determine the proportion of children who meet the clinical criteria for the diagnosis of sinusitis among all children attending primary care pediatric practices, to explore the relationship between passive smoking and the occurrence of sinusitis and to study the role of antibiotics in the management of sinusitis.

DESIGN

A prospective observational cohort study.

SETTING

Outpatient Pediatric Clinics of Jordan University of Science and Technology and Princess Rahma Teaching Hospital. Patients. All children ages 1 to 10 years presenting for any reason to participating practices.

METHODS

Physicians participating in this study completed a questionnaire on all children attending the primary care centers, detailing the presence of nasal congestion or discharge, the duration of symptoms, daytime cough and whether symptoms were improving. The presence or absence of smokers in the family was also recorded. Children meeting our clinical criteria for sinusitis were further evaluated for other signs and symptoms including the type of medication prescribed. The severity of symptoms was reassessed at 10-day follow-up after the first visit.

RESULTS

The study population was composed of 3001 children, of whom 249 met our clinical criteria for diagnosis of sinusitis (8.3%; 95% confidence interval, 7.3 to 9.3%). The prevalence rate of clinical sinusitis was greater among children age 5 years and older than among those younger (9.3% vs. 7.2%, P = 0.04). Children exposed to passive smoking in the household had clinical sinusitis significantly more than those not exposed (68.8% vs. 1.2%, P = 0.00). Antibiotics were prescribed for 80% of children who fulfilled the clinical criteria for diagnosis of sinusitis. Marked improvement of symptoms at the 10-day follow-up visit was reported among those who received antibiotics compared with those who did not (91% vs. 21.4%, P = 0.00).

CONCLUSIONS

Sinusitis is not an uncommon problem in children, passive smoking might be a contributing factor and a course of antibiotic therapy is beneficial.

摘要

目的

确定在初级保健儿科诊所就诊的所有儿童中符合鼻窦炎临床诊断标准的儿童比例，探讨被动吸烟与鼻窦炎发生之间的关系，并研究抗生素在鼻窦炎治疗中的作用。

设计

一项前瞻性观察队列研究。

地点

约旦科技大学门诊儿科诊所和拉赫玛公主教学医院。患者：所有因任何原因到参与研究的诊所就诊的1至10岁儿童。

方法

参与本研究的医生为在初级保健中心就诊的所有儿童填写一份问卷，详细记录鼻塞或流涕情况、症状持续时间、日间咳嗽以及症状是否正在改善。还记录了家庭中是否有吸烟者。符合我们鼻窦炎临床标准的儿童进一步评估其他体征和症状，包括所开药物的类型。在首次就诊后10天的随访中重新评估症状的严重程度。

结果

研究人群由3001名儿童组成，其中249名符合我们的鼻窦炎诊断临床标准（8.3%；95%置信区间，7.3%至9.3%）。5岁及以上儿童的临床鼻窦炎患病率高于5岁以下儿童（9.3%对7.2%，P = 0.04）。在家中接触被动吸烟的儿童患临床鼻窦炎的比例显著高于未接触者（68.8%对1.2%，P = 0.00）。符合鼻窦炎诊断临床标准的儿童中有80%使用了抗生素。与未使用抗生素的儿童相比，接受抗生素治疗的儿童在10天随访时症状有明显改善（91%对21.4%，P = 0.00）。