Chirico G, Quartarone G, Mallefet P
Department of Neonatology and NICU, Children Hospital, Spedali Civili, Brescia, Italy -
Minerva Pediatr. 2014 Dec;66(6):549-57.
The most common causes of nasal obstruction and runny nose in infants and children are infections, mainly of viral origin, or allergies. In neonates and infants viral upper respiratory tract infections (URTI) are frequently observed during episodes of nasal obstruction. Saline irrigation of the nose is believed to alleviate URTI symptoms by helping to eliminate excess mucus, to reduce congestion and by contributing to improve breathing. Objective of the study was to review the efficacy and safety of non-pharmacological options for the treatment of nasal congestion and its sequelae, in infants and children, with a special focus on hypertonic and isotonic solutions and other medical devices, including nasal aspirators. Available data indicate that nasal symptoms in children with allergic rhinitis or acute sinusitis significantly improved following nasal saline irrigation. The use of medical devices is less documented. Nasal aspiration with a medical device, associated with an isotonic saline solution, during viral rhinitis, has been shown to lower the risk of developing acute otitis media and rhinosinusitis, in comparison with a group treated with physiological saline solution alone. Safety and tolerability have been evaluated and no serious adverse events have been reported. Literature data highlighted the good tolerability. The use of isotonic and hypertonic saline solutions to relief nasal congestion in infants and children is widespread; it is a safe and valuable therapeutic support, and can reduce the use of medications (antihistamines, decongestant, antibiotics, corticosteroids) during the treatment of URTIs.
婴儿和儿童鼻塞和流鼻涕最常见的原因是感染，主要是病毒感染，或过敏。在新生儿和婴儿中，鼻塞发作时经常会出现病毒性上呼吸道感染（URTI）。鼻腔盐水冲洗被认为有助于清除过多黏液、减轻充血并改善呼吸，从而缓解URTI症状。本研究的目的是回顾非药物治疗方法对婴幼儿鼻塞及其后遗症的疗效和安全性，特别关注高渗和等渗溶液以及其他医疗设备，包括鼻腔吸引器。现有数据表明，过敏性鼻炎或急性鼻窦炎患儿在鼻腔盐水冲洗后，鼻部症状明显改善。关于医疗设备使用的记录较少。与仅用生理盐水治疗的组相比，在病毒性鼻炎期间使用与等渗盐溶液相关的医疗设备进行鼻腔抽吸，已显示出可降低发生急性中耳炎和鼻-鼻窦炎的风险。已对安全性和耐受性进行了评估，未报告严重不良事件。文献数据强调了良好的耐受性。使用等渗和高渗盐溶液缓解婴幼儿鼻塞的情况很普遍；它是一种安全且有价值的治疗辅助手段，并且可以减少治疗URTI期间药物（抗组胺药、减充血剂、抗生素、皮质类固醇）的使用。
