鼻咽喉清理方案对上呼吸道感染的3岁以下儿童鼻塞及中耳状况的即时影响：一项随机对照试验

Immediate effects of a rhino-pharyngeal clearance protocol in nasal obstruction and middle ear condition of children under 3 years of age with upper respiratory infections: A randomized controlled trial.

作者信息

Alexandrino Ana Silva, Santos Rita, Melo Cristina, Tomé David, Bastos José Mesquita, Postiaux Guy

机构信息

Department of Physiotherapy, School of Health - P.Porto, Portugal; Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.

出版信息

Acta Otorrinolaringol Esp (Engl Ed). 2019 Jul-Aug;70(4):192-199. doi: 10.1016/j.otorri.2018.03.004. Epub 2018 Jun 8.

DOI:10.1016/j.otorri.2018.03.004

PMID:29891397

Abstract

INTRODUCTION AND OBJECTIVES

Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI.

MATERIALS AND METHODS

Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30min of normal activities, in the CG.

RESULTS

In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG=33.3%; CG=68.4%; p=0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0=-124daPa; M1=-92daPa; p=0.022. Right ear: M0=-102daPa; M1=-77daPa; p=0.021), which was not observed in the CG (Left ear: M0=-105daPa; M1=-115daPa; p=0.485. Right ear: M0=-105daPa; M1=-131daPa; p=0.105). There were no significant results concerning the compliance of the tympanic membrane.

CONCLUSIONS

The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI.

摘要

引言与目的

2岁以下儿童呼吸道感染风险高，常需进行鼻腔冲洗治疗。然而，目前对于鼻腔冲洗对鼻咽部和中耳的即时影响尚缺乏足够了解。因此，本研究旨在分析鼻咽喉清理干预方案对3岁以下上呼吸道感染（URTI）儿童鼻塞及中耳状况的影响。

材料与方法

在波尔图的一家日托中心进行随机对照试验，44名儿童被随机分为干预组（IG）和对照组（CG）。在基线期（M0）以及干预后（M1）进行鼻听诊和鼓室图检查，干预措施包括干预组进行鼻腔冲洗（0.9%氯化钠溶液），随后进行强制鼻腔吸气，对照组在正常活动30分钟后进行检查。

结果

与对照组相比，干预组在M1时被分类为鼻腔声音阻塞的儿童频率较低（干预组=33.3%；对照组=68.4%；p=0.042）。我们还观察到干预组平均峰压（PP）有所改善（左耳：M0=-124daPa；M1=-92daPa；p=0.022。右耳：M0=-102daPa；M1=-77daPa；p=0.021），而对照组未观察到这种改善（左耳：M0=-105daPa；M1=-115daPa；p=0.485。右耳：M0=-105daPa；M1=-131daPa；p=0.105）。关于鼓膜顺应性，未得出显著结果。