关键词: 腺样体肥大, 布地奈德, 鼻咽腔前后径距离之比, 视觉模拟量表, 鼻腔冲洗

Abstract: Objective    To study the clinical effect of different doses of budesonide nebulized inhalation and saline nasal irrigation in children with adenoid hypertrophy. Methods    Sixty children （aged 2～5 years） with adenoid hypertrophy attending the outpatient clinic of the Department of Otolaryngology Head and Neck Surgery of the Affiliated Hospital of Fudan University from October 2021 to February 2022 were prospectively collected and randomly assigned to three groups （n=20 for each group） according to the random number table method： high-dose budesonide group （group A，budesonide 1 mg/dose+ saline nasal irrigation），low-dose budesonide group （group B，budesonide 0.5 mg/dose+ salin nasal irrigation） and control group （group C，salin nasal irrigation），with an observation period of 8 weeks. The χ2 test，analysis of variance（ANOVA），and repeated-measures ANOVA were used to compare the clinical efficacy in the children in the three groups. Results    A total of 54 patients were finally included in the statistical analysis. Before the intervention，there were no significant differences in baseline weight，height，A/N ratio，VAS score （including nasal congestion，snoring，cough），VAS total score， arterial oxygen saturation （SaO2）data or pulse among the three groups （P>0.05），and all cases were with nasal obstruction （level Ⅲ）. With the interventions performed，VAS score for nasal congestion（F=232.089，P<0.001），snoring （F=72.520，P<0.001），cough（F=10.636，P=0.002），open-mouth breathing（F=95.325，P<0.001） and total score（F=295.633，P<0.001） all decreased significantly，and SaO2 data （F=161.575，P<0.001） gradually increased. After 8 weeks of intervention，the VAS of nasal symptoms scores and A/N values of patients in group A and group B were significantly lower than those in group C （P<0.05）. SaO2 in group A was higher than that in group C（P<0.05）. A total of 26 adverse events were reported，including 16 cases （61.54%） of cold，which was the most common adverse event. No serious adverse events occurred throughout the study，and the investigated drugs were well-tolerated and safe. Conclusion    Budesonide nebulized inhalation combined with saline nasal irrigation can effectively control the symptoms of children and improve the life quality of children with adenoid hypertrophy，and reduce the degree of adenoid hypertrophy in some children. The treatment is well-tolerated，and has certain clinical promotion value，which can bring clinical benefits to children.However，this study is a small sample size trial，and large sample and multi-center trials are needed to further verify in increaes the credibility of the clinical trial results.

Key words: adenoid hypertrophy, budesonide, A/N, VAS score, nasal irrigation