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2023 S2k 指南：腺样体肥大的诊断和治疗

2023-07-25 HNO 发表于上海

腺样体肥大

腺样体肥大是腺样体（咽扁桃体）的增大，与鼻咽部的机械性阻塞和/或慢性炎症过程有关。

中文标题：

2023 S2k 指南：腺样体肥大的诊断和治疗

英文标题：

Adenoid hypertrophy—​diagnosis and treatment: the new S2k guideline

发布机构：

发布日期：

2023-07-25

简要介绍：

当出现机械性阻塞和/或慢性炎症的鼻咽症状时，应考虑咽扁桃体的病理性增生。慢性咽鼓管功能障碍可导致传导性耳聋、胆脂瘤、复发性急性中耳炎等多种中耳疾病。检查时，应注意是否存在腺样体面容（长脸综合征），即嘴巴永久张开，舌尖可见。如果症状严重和/或保守治疗失败，腺样体切除术通常在门诊进行。传统刮宫术仍然是德国既定的标准治疗方法。组织学评估适用于粘多糖贮积症的临床证据。由于存在出血风险，术前进行出血调查问卷，这是每次小儿手术前必须进行的操作。尽管腺样体切除术正确，腺样体仍有可能复发。出院回家前，应对鼻咽部进行耳鼻喉科检查是否有继发性出血，并获得麻醉许可。

相关资料下载：
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    2024-07-03 ms1000001376245915 来自山东省

    谢谢！

    0

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    2024-06-26 ms8000001450169623 来自安徽省

    谢谢

    0

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    2024-04-01 ms4000001322444039 来自重庆

    腺样体肥大诊断

    0

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    2023-12-12 ms6000000201966816 来自山东省

    腺样体肥大诊断

    0

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    2023-12-12 ms6000000201966816 来自山东省

    腺样体肥大

    0

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患儿腺样体肥大，别着急手术，可以先试试保守治疗！

腺样体肥大作为儿童的常见病、多发病，不仅引起儿童颌面部发育异常，也是儿童分泌性中耳炎、慢性鼻窦炎，儿童 OASHS的主要病因之一，对儿童生理心理发育和认知功能均有重要影响。

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腺样体是位于鼻咽腔顶部、蝶骨体底和枕骨斜坡颅外面的一团淋巴组织。平时也称为：增殖腺、咽扁桃体、Luschka扁桃体等。此环特殊的位置成为吸入性或摄入性抗原最早接触部位,是呼吸道第一道防御门户。

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此次制定明确指南适用范围、规范性引用文件、术语和定义、诊断、辨证、治疗、预防和调护,以期为儿童腺样体肥大中医临床实践、诊疗规范等提供重要参考。

腺样体肥大患儿，凝血异常，是否该手术呢？

患儿，男，3岁，家属诉患儿于2年前无明显诱因开始出现睡眠时打鼾，伴咳嗽，偶有憋气，伴张口呼吸。年初来我院行电子鼻咽镜检查示：鼻咽顶壁腺样体遮挡后鼻孔＞2/3。未行特殊治疗。

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