妊娠鼻炎的病因及处理。

Eva K Ellegård
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引用次数: 45

摘要

妊娠期鼻炎定义为妊娠最后6周或更长时间内出现鼻塞,无其他呼吸道感染体征,无已知过敏原因,分娩后2周内症状完全消退。妊娠鼻炎发生在大约五分之一的妊娠中,几乎可以在任何妊娠周出现,并影响妇女和胎儿。妊娠期鼻炎的发病机制尚不清楚,但可能与胎盘生长激素有关。吸烟和对室内尘螨过敏是可能的危险因素。鼻窦炎通常很难鉴别诊断:鼻塞减充血的鼻内窥镜检查是诊断方法的选择。在某些情况下,超声波或x射线可能是必要的。鼻窦炎应积极治疗,增加剂量的-内酰胺类抗生素和窦灌洗。鼻减充血剂对妊娠鼻炎有很好的暂时缓解作用,但它们往往被过度使用,导致鼻炎药物性发展。皮质类固醇尚未被证明对妊娠鼻炎有效,在妊娠期间应避免全身使用。当有其他类型鼻炎的适应症时,可给孕妇使用鼻皮质类固醇。鼻翼扩张器和生理盐水冲洗是缓解鼻塞的安全方法,但妊娠鼻炎的最终治疗方法仍有待发现。
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The etiology and management of pregnancy rhinitis.

Pregnancy rhinitis is defined as nasal congestion in the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection and with no known allergic cause, with complete resolution of symptoms within 2 weeks after delivery. Pregnancy rhinitis occurs in approximately one-fifth of pregnancies, can appear at almost any gestational week, and affects the woman and possibly also the fetus. The pathogenesis of pregnancy rhinitis is not clear, but placental growth hormone is suggested to be involved. Smoking and sensitization to house dust mites are probable risk factors. It is often difficult to make a differential diagnosis from sinusitis: nasendoscopy of a decongested nose is the diagnostic method of choice. In some cases ultrasound or x-ray may be necessary. Sinusitis should be treated aggressively with increased doses of beta-lactam antibiotics and antral irrigation. Nasal decongestants give good temporary relief from pregnancy rhinitis, but they tend to be overused, leading to the development of rhinitis medicamentosa. Corticosteroids have not been shown to be effective in pregnancy rhinitis, and their systemic administration should be avoided during pregnancy. Nasal corticosteroids may be administered to pregnant women when indicated for other sorts of rhinitis. Nasal alar dilators and saline washings are safe means to relieve nasal congestion, but the ultimate treatment for pregnancy rhinitis remains to be found.

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