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目的 :探讨原发性肾病综合征行糖皮质激素治疗过程中扁桃体摘除的临床疗效及可行性。方法 :观察临床病人 3例 ,均为原发性肾病综合征病人 ,且皆应用糖皮质激素 ,其中 1例加用了细胞毒药物。治疗过程中两者都诱发了扁桃体炎症。在糖皮质激素不变的情况下 ,对此 2例行局麻下扁桃体摘除术。结果 :于术后短时间内 ( 2周 )水肿消退 ,尿常规检查正常。均按常规将激素逐渐减量 ,维持量服用 9个月至 1年时间 ,均达到临床治愈。此后 ,继续追踪 1年无复发。结论 :对于原发性肾病综合征病人 ,在应用糖皮质激素治疗过程中尽早行机会致病菌感染的病灶扁桃体的摘除 ,临床疗效确切 ,具有可行性。
Objective: To investigate the clinical efficacy and feasibility of tonsillectomy during primary glucocorticoid therapy in patients with primary nephrotic syndrome. Methods: Three cases of clinical patients were observed, all patients with primary nephrotic syndrome, and all the application of glucocorticoid, of which 1 case added with cytotoxic drugs. Both have induced tonsil inflammation during the course of treatment. In the case of glucocorticoid unchanged, the two cases under local anesthesia tonsillectomy. Results: In a short period of time after surgery (2 weeks) edema subsided, urine routine examination was normal. According to the conventional hormone gradually tapering, the maintenance dose taking 9 months to 1 year, have reached clinical cure. Since then, continue to track 1 year without recurrence. CONCLUSION: It is feasible to remove tonsils from patients with idiopathic nephrotic syndrome who have opportunistic pathogens infection as early as possible during glucocorticoid therapy.