乳幼児の鼻・副鼻腔炎に対する鼻腔内薬液注入療法について

INTRANASAL DRUG INSTILLATION TREATMENT FOR RHINITIS AND SINUSITIS IN CHILDREN

　I．はじめに

　乳幼児の鼻・副鼻腔炎は，耳鼻科医のみならず，小児科の第一線医にとってごく日常的な病気であるにもかかわらず，吸引^10），点鼻^6,8），あるいは薬液噴霧（ボスミン^10），ナファゾリン^6）など）などを行っているが，積極的な治療法はほとんど行われていない。ナファゾリンは持続性があるが，また毒性もあり^4），ボスミンは手軽な点鼻，噴霧剤ではあるが，積極的治療とはいえない。内服^2,12）を用いているものもある。

　プロタルゴール点鼻は副作用の恐れのあるためか，あまり最近では行われていない。

　Intranasal drug instillation treatment was performed and its effects were evaluated in 118 children, 72 boys and 46 girls from infants to 5 years of age, suffering from rhinitis and paranasal sinusitis during Dec. 1975 to June 1976. The drug solution consisted of 0.5ml of streptomycin sulfate (1.0 g in 20ml of distilled water) and 0.5 ml of 10% Isoxasol as a single dose. The nasal cavity was painted with epinephrine solution (Bosmin) and 1.0ml of the solution was flushed into the middle meatus in each nasal cavity with a syringe with a long needle. The patients were treated for 1 to 44 days, averaged 8.0±1.4 days. The period of treatment differed according to type of nasal secretion. PH of nasal secretion was also examined, and it varied at the first visit of patients and then the value approached to pH 6.8 during treatment or at the end of treatment. Bacterial examination of nasal secretion was also performed, and Slapylococcus epdermidis was mostly detected. The effect of the treatment was remarkable for the cases with bacteria sensitive to streptomycin.

　The overall effect of the treatment was estimated as excellent in 103 (87.3%), good in 5 (4.2%) and unsatisfactory in 10 (8.5%). The effect of the treatment was thought due to antibacterial effect of the drugs absorbed into mucous membrane and the irrigation effect of the drug solution in the middle meatus.