目的 对小儿复杂阑尾炎患儿分别应用开腹手术、腹腔镜手术治疗,并比较其临床疗效.方法 选取2019年3月-2021年3月,在我院治疗的82例小儿复杂阑尾炎患儿,将其分为两组.对照组41例,采取开腹手术治疗;观察组41例,采取腹腔镜手术治疗.结果 与对照组对比,观察组患儿的切口更小,出血量更少,术后排气、住院时间更短,术后12h VAS评分更低,差异明显(P<0.05).结论 对小儿复杂阑尾炎患儿应用腹腔镜手术治疗可降低手术创伤,缩短术后恢复时间,减轻术后疼痛程度,值得推广.

Objective To investigate the etiology of child intractable cough to provide a basis for its clinical treatment. Methods The clinical data in 396 children patients with intractable cough in the hospital from February 2013 to July 2016 were ret-rospectively analyzed.Their clinical symptoms,complications and electronic nasopharyngolaryngoscopic examination results were summarized.The formation causes and treatment effect of intractable cough were analyzed.Results Among 396 children cases ac-cording to whether complicating nasal diseases,42 cases(10.61%)had no complicating nasal disease and other 354 cases(89.39%) were combined with nasal diseases.In 354 cases of complicating nasal diseases,285 cases(80.51%)were diagnosed as upper airway cough syndrome,69 cases(19.49%)were simple complicating nasal disease.The clinical symptoms in 285 cases of upper airway cough syndrome were analyzed,201 cases had the nasal symptoms of stuffy nose,runny nose,nasal itching,189 cases had regular cough,63 cases had self inductance of postnasal drip,129 cases had oropharynx visible nasopharynx purulent secretion,267 cases had purulent or sticky secretion in nasopharynx by the first time electronic nasopharyngolaryngoscopy,162 cases had lymphoid folli-cles hyperplasia in the wall of pharynx,174 cases had purulent secretion in nasal meatus and 87 cases had snoring or mouth breath-ing.354 cases of complicating nasal diseases were treated in the otolaryngology department of our hospital,the cough symptom was significantly relieved within 14 d,in which the cough relief rates within 7,14 d in the cases of complicating upper airway cough syn-drome were higher than those in the cases of simple complicating nasal diseases,the difference was statistically significant(P <0.05).Conclusion The proportion of complicating nasal disease and upper airway cough syndrome in children patients with intrac-table cough is higher,and giving targeted therapy can effectively alleviate the cough symptom.

Objective To investigate the clinical effect of Xuanshenshengma decoction combined with compound oxygen in the treatment of chronic cough in children. Methods 88 children with chronic cough were divided into observation group and control group, each group had 44 cases. The control group was treated with the compound. The observation group was given Xuanshenshengma Decoction on the basis of the control group. The changes of serum indexes (TNF-a, IL-6, IgE) and pulmo-nary function indexes (FVC, PEF, TLC, FEV1) were detected before and after treatment. Results The treatment effect of the observation group was better than that of the control group. The difference was statistically significant. After treatment, the levels of TNF-a, IL-6 and IgE in the two groups were significantly lower than those before treatment . After treatment, the TNF-a, IL-6 and IgE in the observation group were significantly lower than those in the control group. The difference was statistically significant. After treatment, the levels of FVC, PEF, TLC and FEV1 in the two groups were significantly higher than those be-fore treatment. After treatment, the FVC, PEF, TLC and FEV1 in the observation group were significantly higher than those in the control group. The difference was statistically significant. Conclusion The combination of Xuanshenshengma Decoction and compound oxygen can significantly reduce the inflammatory reaction and improve the lung function of children with chronic cough.

Objective To evaluate the effect of Tulobuterol Patch on children with cough variant asthma serum inflamma-tory factors. Methods 78 children with cough variant asthma were divided into observation group and control group. The con-trol group was given routine symptomatic treatment. The observation group in the control group based on the treatment given to Tulobuterol Patch. The changes of pulmonary function (PEF, FEV1, FVC, FEV1/FVC) and inflammatory factors (IFN-r, IL-4, IFN-r/IL-4) were compared between the two groups before and after treatment. Results The total effective rate of the observa-tion group was significantly higher than that of the control group (92.31% vs 71.79%). The difference was statistically signifi-cant. PEF, FEV1, FVC and FEV1/FVC were significantly increased after treatment in the two groups. After treatment, the PEF, FEV1, FVC and FEV1/FVC in the observation group were significantly higher than those in the control group. The difference was statistically significant. IFN-r and IFN-r/IL-4 were significantly increased in the two groups after treatment, IL-4 was sig-nificantly lower. After treatment, the IFN-r and IFN-r/IL-4 in the observation group were significantly higher than those in the control group, IL-4 was significantly lower than that in the control group. The difference was statistically significant. Conclu-sion Tulobuterol Patch can significantly reduce the inflammatory response in children with cough variant asthma, improve lung function.

Objective To explore the feasibility of C14-urea breath test in the diagnosis of child chronic cough.Methods One hundred and twenty children cases of chronic cough were collected as the research subjects and divided into the C14 group(adopting C14-urea breath test for diagnosis) and combined group(C14-urea breath test combined with routine diagnostic method) according to different diagnostic means,60 in each group.Then the positive diagnostic rate and effectiveness were analyzed and compared between the two diagnostic methods.Furthermore the ROC curve was adopted to evaluate its diagnostic value.Results The positive diagnosis rate in the C14 group was 76.67%,which was significantly lower than 95.00% in combined groups,the difference was statistically significant (P<0.001).The sensitivity and positive predictive value in the combined group were obviously higher than those in the C14 group (P<0.01),but there were no statistically significant differences in specificity and negative predictive value between the two methods (P>0.05).The expression levels of serum hs-CRP and IL-6 in the C14 group were significantly higher than those in the combined group,but the expression level of IL-10 was obviously lower than that of the combined group (P<0.05).The AUC in the ROC curve of combined group was significantly higher than that of the C14 group(P<0.05).Conclusion The C14-urea breath test can serve as a supplementary diagnosis means in child chronic cough,and its combining with the routine diagnosis method can significantly increase the diagnosis effectiveness.

Objective To study the effect of endoscopic sinus surgery-based comprehensive treatment on chronic sinusitisin children with asthma and its effect on pulmonary ventilation function.Methods Sixty-eight patients with chronic sinusitis and asthma were divided into control group and observation group according to the treatment(34 cases in each group).The control group was treated with conventional conservative treatment.The observation group was treated by endoscopic sinus surgery and perioperative routine treatment.The clinical curative effect and changes of pulmonary ventilation function were observed in both groups.Results The relief of asthma symptoms in the first and third year after surgerywas significantly higher than that in the control group (P ＜0.05).The decline of VAS score and the endoscopic LK score of the observation group was significantly higher than the control group,the difference was statistically significant (P ＜ 0.05);The patients of observation group with improved pulmonary ventilation function were significantly better than the control group in the first and third year after treatment,the difference was statistically significant(P ＜ 0.05).Conclusion Endoscopic sinus surgery-based comprehensive treatment can not only relieve chronic sinusitis in children with asthma,but also control the further development of asthma and improve pulmonary ventilation function,which can be used in clinical practice.

目的 研究学龄前鼻炎所致慢性咳嗽患儿的嗓音学变化.方法 选取220例学龄前鼻炎所致慢性咳嗽患儿和100例健康体检儿童分别作为咳嗽组和对照组,分析两组基频(F0)、基频微扰(Jitter)、振幅微扰(Shimmer)及声门噪声能量(NNE)变化,并采用Logistic回归分析这些指标与鼻炎所致慢性咳嗽之间的相关性.结果 咳嗽组Jitter、Shimmer及NNE得分均明显高于对照组(P<0.05),但两组F0参数差异无统计学意义(P>0.05);鼻炎所致慢性咳嗽能够明显影响患儿Jitter和Shimmer(P<0.05);咳嗽组FVC、PEF25、MMF及FEV 1.0水平均明显低于对照组(P<0.05).结论 Jitter及Shimmer可以作为鼻炎所致咳嗽诊断的诊断指标.

目的:研究SOX9在喉鳞癌组织中的表达以及S期组分(S phase fraction,SPF)的变化,探讨与肿瘤发生发展的关系.方法:采用免疫组织化学方法检测60例喉鳞癌(喉癌组)与32例正常喉黏膜组织(对照组)中SOX9蛋白表达变化,应用图像分析技术检测SOX9阳性表达产物的面密度及积分光密度值变化,同时采用流式细胞术检测喉癌组与对照组组织中SPF变化.结果:喉癌组面密度及积分光密度值较对照组升高,两组比较差异有显著性(P＜0.01).喉鳞癌组织中SOX9蛋白表达升高,喉鳞癌组织中SOX9蛋白表达与对照组比较差异有显著性(P＜0.01).喉癌组SPF高于对照组,二者差异有统计学意义(P＜0.01).结论:SOX9蛋白异常表达及SPF变化可能在喉鳞癌发生发展中发挥重要作用.

目的 探析尾型同源盒转录因子-2(Caudal type homeobox transcription factor-2,CDX2)在喉癌(laryngeal carcinoma,LC)组织中的表达及其作用.方法 采用免疫组织化学方法(Immunohistochemistry,IHC)检测两种组织中CDX2蛋白的表达,比较喉癌与声带息肉组织中CDX2面密度值及其积分光密度值的变化.结果 CDX2蛋白呈棕黄色颗粒,主要表达位于细胞核.对照组CDX2的表达无论在强度或细胞数量上均高于实验组,二组间差异有统计学意义(P＜0.01).结论 CDX2在喉癌组织中表达异常,CDX2异常表达可能在喉癌发生发展过程中发挥重要作用.

目的:探讨微创手术治疗声门型早期喉癌及癌前病变的临床疗效.方法:选择于2012年12月~2013年12月在我院治疗的声门型早期喉癌及癌前病变患者100例,随机分为观察组和对照组,每组50例,观察组采用低温等离子射频消融术治疗,对照组采用传统口切开手术治疗,比较两组近期疗效及复发情况.结果:①术后,观察组患者的黏膜恢复情况明显好于对照组,组间差异具统计学意义(P<0.05);②1年后,观察组复发率为0.0%(0/50),对照组复发率为8.0%(4/50),组间差异具统计学意义(P<0.05).结论:微创手术治疗声门型早期喉癌及癌前病变具有术后恢复好,复发率低的优点,值得推广应用.

目的 总结新生儿声带麻痹的病因.方法 回顾性分析我院确诊为声带麻痹的34例新生儿的临床资料,均进行纤维喉镜检查,对确诊者行胸部X线、心电图及心脏彩超检查,对声带麻痹的临床表现、引起声带麻痹的病因进行总结.结果 34例声带麻痹患儿中以左侧麻痹最为常见,占82.35％;最常见的临床症状为喉鸣,占44.12％.病因依次为:先心病和卵圆孔未闭(61.84％)、产伤(11.76％)、缺血缺氧性脑病(8.82％)、病毒感染(8.82％)、原因不明(8.82％).结论 先心病和卵圆孔未闭是新生儿声带麻痹最常见原因,其次为产伤、缺血缺氧性脑病及病毒感染.

Objective To study blood oxygen saturation changes of children with OSAHS anti reflux before and af-ter treatment.Methods 50 cases of children with OSAHS hospitalized from February 2012 to February 2014 in our hospital were as observation group ,another 50 cases of healthy children were selected as control group.Blood oxygen saturation of all the study objects before and after treatment were detected of patients of the observation group,its changes were observed and analyzed.Results The study objects of two groups before treatment,average lowest oxygen saturation of the observation group was significantly lower than the level of control group,the difference had statistical significance (P < 0.05);After treatment ,there were still differences between nocturnal average the lowest oxygen sat-uration of the study objects of two groups ,but level of the observation group was improved effectively.The comparison of whole blood reduced viscosity and erythrocyte aggregation index level of study objects of two groups ,the two inde-xes of the observation group were improved,the difference had statistical significance(P <0.05).The study objects of two groups before treatment of observation group,the number of red cells and hemoglobin had significant difference,the difference had statistical significance (P < 0.05).;After treatment of the observation group ,there were no significant differences between the numbers of red blood cell count and hemoglobin of two groups.Conclusion Children with OS-AHS are given anti reflux treatment and can improve children's blood oxygen saturation ,but OSAHS cannot be cured. Therefore,anti reflux treatment for children with OSAHS was only as auxiliary way.

目的：探讨喉镜引导下低温等离子射频消融术治疗声带麻痹的临床疗效。方法30例声带麻痹患者，嗓音听感知一致性分级（ CAPE-V）均为4级；均采用喉镜辅助下低温等离子射频消融术治疗。观察术中出血情况，术后并发症（出血、呼吸困难和味觉障碍）发生情况，随访1年，行CAPE-V评估并判定疗效，观察复发情况。结果30例患者手术均成功，术中出血量为8～13（9．44±2．97）mL。术后均安全拔管，除1例术后4～10d出现继发出血（出血量约60 mL）外，其余患者未出现并发症。术后1个月26例见声门后部愈合之黏膜光滑，4例有粟粒大小肉芽形成，不影响呼吸，术后2个月肉芽消失。 CAPE-V分级明显低于术前；术后随访3～14个月无复发病例，治愈率为70％，总有效率为100％。结论喉镜辅助下低温等离子射频消融术治疗声带麻痹临床疗效显著，且较为安全。

目的:分析引起新生儿、婴儿声带麻痹的原因.方法:对2002年5月～2010年5月21例声带麻痹患儿的临床资料进行回顾性分析.结果:先天性心脏病居首位,共有18例,占85.7％；缺血缺氧性脑病2例,占9.5％；即有先心病又有缺血缺氧性脑病的1例,占4.7％.结论:在新生儿、婴儿的声带麻痹中,先心病为最主要原因,其次为缺血缺氧性脑病.

目的多种扁桃体切除术是对扁桃体剥离切除术;挤切术;部分切除术;次全切除术;微波热凝术;低温等离子射频切除术的对比观察。方法选用扁桃体剥离切除术和挤切式切除术与扁桃体部分切除,次全切除,微波热凝术,低温等离子射频切除术的方法,通过临床术后的患者随诊观察。结果扁桃体剥离切除和挤切式切除术属于传统的扁桃体全部切除术。扁桃体部分切除,次全切除,微波热凝切除,低温等离子射频切除等方法均为扁桃体部分切除术,术中保留一定的扁桃体组织,扁桃体被膜及扁桃体间隙。结论扁桃体部分切除和次全切除术通过临床观察优越于扁桃体全切术,同时减少了对全身的伤害,对2～5岁免疫功能最活跃时期的儿童更加重要,为扁桃体切除术提供了一个很好的治疗途径。

目的探讨1.5-5岁低龄儿童扁桃体切除术方法。方法选1.5-5岁低龄儿童作扁桃次全切除与扁桃体全部切除的对比观察。结果扁桃体次全切除,术中保留一定的扁桃体组织,扁桃体被膜及扁桃体间隙,术后咽部无瘢痕。结论扁桃体次全切除术,通过临床观察优越于扁桃体全部切除术,同时减少了对全身的伤害,对2-5岁免疫功能最活跃时期的儿童更加重要,为扁桃体切除术提供了一个很好的治疗途径。

目的 探讨扁桃体次全切除与全部切除的临床效果.方法 以扁桃体上隐窝底线为标志,纵行切开扁桃体,再应用鼻窦刨削器切除大部分扁桃体,保留部分扁桃体腺体组织,扁桃体被膜,扁桃体周围间隙.结果 扁桃体次全切除与较全部切除比较,两者治愈率无明显差异,手术出血量两者有明显差异,扁桃体次全切除手术出血量少.结论 扁桃体次全切除手术方法,达到了"保护扁桃体的免疫功能,去除因扁桃体病变带来的全身伤害"的目的 ,较扁桃体全切手术方法有明显优势.

<正>我院1998年7月至2005年6月共收治喉、气管及支气管特殊异物38例,报道如下。1.1临床资料。喉、气管及支气管特殊异物患者共38例。年1资料与方法

<正>我院于2002年1月～2005年1月共行单纯扁桃体肥大切除术60例,其中扁桃体部分切除30例,传统剥离圈套式和快速挤切式扁桃体全切除术30例。分析报道如下。