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Диагностика и лечение острого синусита в амбулаторной практике
Диагностика и лечение острого синусита в амбулаторной практике
Пальчун В.Т., Дербенева М.Л., Гусева А.Л. Диагностика и лечение острого синусита в амбулаторной практике. Справочник поликлинического врача. 2019; 1: 24–29.
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Аннотация
В статье представлены этиология, клиническая картина и диагностические критерии острого синусита. Авторы рассматривают различное течение заболевания при вирусной и бактериальной этиологии, а также показания и сроки начала назначения антибактериальной терапии. Обсуждаются препараты для стартовой антибактериальной и сопутствующей вспомогательной терапии. Приводится разбор типичного клинического случая острого синусита из амбулаторной практики.
Ключевые слова: синусит, риносинусит, антибиотики.
Key words: sinusitis, rhinosinusitis, antibiotics.
Ключевые слова: синусит, риносинусит, антибиотики.
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Key words: sinusitis, rhinosinusitis, antibiotics.
Полный текст
Список литературы
1. Крюков А.И., Студеный М.Е., Артемьев М.Е. и др. Лечение пациентов с риносинуситами: возможности консервативного и оперативного воздействия. Медицинский совет. 2012; 11: 52–6. / Kriukov A.I., Studenyi M.E., Artem'ev M.E. i dr. Lechenie patsientov s rinosinusitami: vozmozhnosti konservativnogo i operativnogo vozdeistviia. Meditsinskii sovet. 2012; 11: 52–6. [in Russian]
2. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 2014; 10 (260): 1–161.
3. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152 (Suppl. 2): S1–S39. DOI: 10.1177/0194599815572097
4. Fokkens WJ, Lund VJ, Mullol J et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012; 50 (1): 1–12. DOI: 10.4193/Rhino50E2
5. Рязанцев С.В., Карнеева О.В., Гаращенко Т.И. и др. Острый синусит. Клинические рекомендации Национальной медицинской ассоциации оториноларингологов. М., 2016. / Riazantsev S.V., Karneeva O.V., Garashchenko T.I. i dr. Ostryi sinusit. Klinicheskie rekomendatsii Natsional'noi meditsinskoi assotsiatsii otorinolaringologov. M., 2016. [in Russian]
6. Brook I, Hausfeld JN. Microbiology of acute and chronic maxillary sinusitis in smokers and nonsmokers. Ann Otol Rhinol Laryngol 2011; 120 (11): 707–12.
7. Tan RA, Corren J. The relationship of rhinitis and asthma, sinusitis, food allergy, and eczema. Immunol Allergy Clin North Am 2011; 31 (3): 481–91. DOI: 10.1016/j.iac.2011.05.010
8. Радциг Е.Ю., Малыгина Л.В., Лапицкая А.С. Роль респираторных вирусов в этиологии риносинусита у детей. Вестн. оториноларингологии. 2014; 6: 39–40. DOI: 10.17116/otorino201439-40 / Radtsig E.Iu., Malygina L.V., Lapitskaia A.S. Rol' respiratornykh virusov v etiologii rinosinusita u detei. Vestn. otorinolaringologii. 2014; 6: 39–40. DOI: 10.17116/otorino201439-40 [in Russian]
9. Puhakka T, Mäkelä MJ, Alanen A et al. Sinusitis in the common cold. J Allergy Clin Immunol 1998; 102 (3): 403–8.
10. Острый риносинусит: клинические рекомендации. Под ред. А.С.Лопатина. Российское общество ринологов. М., 2017. / Ostryi rinosinusit: klinicheskie rekomendatsii. Pod red. A.S.Lopatina. Rossiiskoe obshchestvo rinologov. M., 2017. [in Russian]
11. Desrosiers M, Evans GA, Keith PK et al. Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Allergy Asthma Clin Immunol 2011; 7 (1): 2. DOI: 10.1186/1710-1492-7-2
12. Van den Broek MF, Gudden C, Kluijfhout WP et al. No evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent rhinorrhea: a systematic review of the evidence base. Otolaryngol Head Neck Surg 2014; 150 (4): 533–7. DOI: 10.1177/0194599814522595
13. Lacroix JS, Ricchetti A, Lew D et al. Symptoms and clinical and radiological signs predicting the presence of pathogenic bacteria in acute rhinosinusitis. Acta Otolaryngol 2002; 122 (2): 192–6.
14. Hoxworth JM, Glastonbury CM. Orbital and intracranial complications of acute sinusitis. Neuroimaging Clin N Am 2010; 20 (4): 511–26. DOI: 10.1016/j.nic.2010.07.004
15. Lemiengre MB, van Driel ML, Merenstein D et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev 2012; 10: CD006089. DOI: 10.1002/14651858.CD006089.pub4
16. Клинические рекомендации. Острый синусит. Министерство здравоохранения Российской Федерации. Национальная медицинская ассоциация оториноларингологов, 2016 год. / Klinicheskie rekomendatsii. Ostryi sinusit. Ministerstvo zdravookhraneniia RF. Natsional'naia meditsinskaia assotsiatsiia otorinolaringologov, 2016. [in Russian]
17. FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Silver Spring, MD: Food and Drug Administration, 2016. http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm
18. Эмпирическая антибактериальная терапия инфекций дыхательных путей с учетом факторов риска резистентной флоры. Резолюция совета экспертов. Справочник поликлинического врача. 2018; 1: 28–32. / Resolution of the Expert Council "Empirical antibacterial therapy of respiratory infections and the risk factors of resistant flora". Handbook for Practitioners Doctors. 2018; 1: 28–32.[in Russian]
2. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 2014; 10 (260): 1–161.
3. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152 (Suppl. 2): S1–S39. DOI: 10.1177/0194599815572097
4. Fokkens WJ, Lund VJ, Mullol J et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012; 50 (1): 1–12. DOI: 10.4193/Rhino50E2
5. Riazantsev S.V., Karneeva O.V., Garashchenko T.I. i dr. Ostryi sinusit. Klinicheskie rekomendatsii Natsional'noi meditsinskoi assotsiatsii otorinolaringologov. M., 2016. [in Russian]
6. Brook I, Hausfeld JN. Microbiology of acute and chronic maxillary sinusitis in smokers and nonsmokers. Ann Otol Rhinol Laryngol 2011; 120 (11): 707–12.
7. Tan RA, Corren J. The relationship of rhinitis and asthma, sinusitis, food allergy, and eczema. Immunol Allergy Clin North Am 2011; 31 (3): 481–91. DOI: 10.1016/j.iac.2011.05.010
8. Radtsig E.Iu., Malygina L.V., Lapitskaia A.S. Rol' respiratornykh virusov v etiologii rinosinusita u detei. Vestn. otorinolaringologii. 2014; 6: 39–40. DOI: 10.17116/otorino201439-40 [in Russian]
9. Puhakka T, Mäkelä MJ, Alanen A et al. Sinusitis in the common cold. J Allergy Clin Immunol 1998; 102 (3): 403–8.
10. Ostryi rinosinusit: klinicheskie rekomendatsii. Pod red. A.S.Lopatina. Rossiiskoe obshchestvo rinologov. M., 2017. [in Russian]
11. Desrosiers M, Evans GA, Keith PK et al. Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Allergy Asthma Clin Immunol 2011; 7 (1): 2. DOI: 10.1186/1710-1492-7-2
12. Van den Broek MF, Gudden C, Kluijfhout WP et al. No evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent rhinorrhea: a systematic review of the evidence base. Otolaryngol Head Neck Surg 2014; 150 (4): 533–7. DOI: 10.1177/0194599814522595
13. Lacroix JS, Ricchetti A, Lew D et al. Symptoms and clinical and radiological signs predicting the presence of pathogenic bacteria in acute rhinosinusitis. Acta Otolaryngol 2002; 122 (2): 192–6.
14. Hoxworth JM, Glastonbury CM. Orbital and intracranial complications of acute sinusitis. Neuroimaging Clin N Am 2010; 20 (4): 511–26. DOI: 10.1016/j.nic.2010.07.004
15. Lemiengre MB, van Driel ML, Merenstein D et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev 2012; 10: CD006089. DOI: 10.1002/14651858.CD006089.pub4
16. Klinicheskie rekomendatsii. Ostryi sinusit. Ministerstvo zdravookhraneniia RF. Natsional'naia meditsinskaia assotsiatsiia otorinolaringologov, 2016. [in Russian]
17. FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Silver Spring, MD: Food and Drug Administration, 2016. http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm
18. Resolution of the Expert Council "Empirical antibacterial therapy of respiratory infections and the risk factors of resistant flora". Handbook for Practitioners Doctors. 2018; 1: 28–32.[in Russian]
2. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 2014; 10 (260): 1–161.
3. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152 (Suppl. 2): S1–S39. DOI: 10.1177/0194599815572097
4. Fokkens WJ, Lund VJ, Mullol J et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012; 50 (1): 1–12. DOI: 10.4193/Rhino50E2
5. Рязанцев С.В., Карнеева О.В., Гаращенко Т.И. и др. Острый синусит. Клинические рекомендации Национальной медицинской ассоциации оториноларингологов. М., 2016. / Riazantsev S.V., Karneeva O.V., Garashchenko T.I. i dr. Ostryi sinusit. Klinicheskie rekomendatsii Natsional'noi meditsinskoi assotsiatsii otorinolaringologov. M., 2016. [in Russian]
6. Brook I, Hausfeld JN. Microbiology of acute and chronic maxillary sinusitis in smokers and nonsmokers. Ann Otol Rhinol Laryngol 2011; 120 (11): 707–12.
7. Tan RA, Corren J. The relationship of rhinitis and asthma, sinusitis, food allergy, and eczema. Immunol Allergy Clin North Am 2011; 31 (3): 481–91. DOI: 10.1016/j.iac.2011.05.010
8. Радциг Е.Ю., Малыгина Л.В., Лапицкая А.С. Роль респираторных вирусов в этиологии риносинусита у детей. Вестн. оториноларингологии. 2014; 6: 39–40. DOI: 10.17116/otorino201439-40 / Radtsig E.Iu., Malygina L.V., Lapitskaia A.S. Rol' respiratornykh virusov v etiologii rinosinusita u detei. Vestn. otorinolaringologii. 2014; 6: 39–40. DOI: 10.17116/otorino201439-40 [in Russian]
9. Puhakka T, Mäkelä MJ, Alanen A et al. Sinusitis in the common cold. J Allergy Clin Immunol 1998; 102 (3): 403–8.
10. Острый риносинусит: клинические рекомендации. Под ред. А.С.Лопатина. Российское общество ринологов. М., 2017. / Ostryi rinosinusit: klinicheskie rekomendatsii. Pod red. A.S.Lopatina. Rossiiskoe obshchestvo rinologov. M., 2017. [in Russian]
11. Desrosiers M, Evans GA, Keith PK et al. Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Allergy Asthma Clin Immunol 2011; 7 (1): 2. DOI: 10.1186/1710-1492-7-2
12. Van den Broek MF, Gudden C, Kluijfhout WP et al. No evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent rhinorrhea: a systematic review of the evidence base. Otolaryngol Head Neck Surg 2014; 150 (4): 533–7. DOI: 10.1177/0194599814522595
13. Lacroix JS, Ricchetti A, Lew D et al. Symptoms and clinical and radiological signs predicting the presence of pathogenic bacteria in acute rhinosinusitis. Acta Otolaryngol 2002; 122 (2): 192–6.
14. Hoxworth JM, Glastonbury CM. Orbital and intracranial complications of acute sinusitis. Neuroimaging Clin N Am 2010; 20 (4): 511–26. DOI: 10.1016/j.nic.2010.07.004
15. Lemiengre MB, van Driel ML, Merenstein D et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev 2012; 10: CD006089. DOI: 10.1002/14651858.CD006089.pub4
16. Клинические рекомендации. Острый синусит. Министерство здравоохранения Российской Федерации. Национальная медицинская ассоциация оториноларингологов, 2016 год. / Klinicheskie rekomendatsii. Ostryi sinusit. Ministerstvo zdravookhraneniia RF. Natsional'naia meditsinskaia assotsiatsiia otorinolaringologov, 2016. [in Russian]
17. FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Silver Spring, MD: Food and Drug Administration, 2016. http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm
18. Эмпирическая антибактериальная терапия инфекций дыхательных путей с учетом факторов риска резистентной флоры. Резолюция совета экспертов. Справочник поликлинического врача. 2018; 1: 28–32. / Resolution of the Expert Council "Empirical antibacterial therapy of respiratory infections and the risk factors of resistant flora". Handbook for Practitioners Doctors. 2018; 1: 28–32.[in Russian]
________________________________________________
2. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 2014; 10 (260): 1–161.
3. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152 (Suppl. 2): S1–S39. DOI: 10.1177/0194599815572097
4. Fokkens WJ, Lund VJ, Mullol J et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012; 50 (1): 1–12. DOI: 10.4193/Rhino50E2
5. Riazantsev S.V., Karneeva O.V., Garashchenko T.I. i dr. Ostryi sinusit. Klinicheskie rekomendatsii Natsional'noi meditsinskoi assotsiatsii otorinolaringologov. M., 2016. [in Russian]
6. Brook I, Hausfeld JN. Microbiology of acute and chronic maxillary sinusitis in smokers and nonsmokers. Ann Otol Rhinol Laryngol 2011; 120 (11): 707–12.
7. Tan RA, Corren J. The relationship of rhinitis and asthma, sinusitis, food allergy, and eczema. Immunol Allergy Clin North Am 2011; 31 (3): 481–91. DOI: 10.1016/j.iac.2011.05.010
8. Radtsig E.Iu., Malygina L.V., Lapitskaia A.S. Rol' respiratornykh virusov v etiologii rinosinusita u detei. Vestn. otorinolaringologii. 2014; 6: 39–40. DOI: 10.17116/otorino201439-40 [in Russian]
9. Puhakka T, Mäkelä MJ, Alanen A et al. Sinusitis in the common cold. J Allergy Clin Immunol 1998; 102 (3): 403–8.
10. Ostryi rinosinusit: klinicheskie rekomendatsii. Pod red. A.S.Lopatina. Rossiiskoe obshchestvo rinologov. M., 2017. [in Russian]
11. Desrosiers M, Evans GA, Keith PK et al. Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Allergy Asthma Clin Immunol 2011; 7 (1): 2. DOI: 10.1186/1710-1492-7-2
12. Van den Broek MF, Gudden C, Kluijfhout WP et al. No evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent rhinorrhea: a systematic review of the evidence base. Otolaryngol Head Neck Surg 2014; 150 (4): 533–7. DOI: 10.1177/0194599814522595
13. Lacroix JS, Ricchetti A, Lew D et al. Symptoms and clinical and radiological signs predicting the presence of pathogenic bacteria in acute rhinosinusitis. Acta Otolaryngol 2002; 122 (2): 192–6.
14. Hoxworth JM, Glastonbury CM. Orbital and intracranial complications of acute sinusitis. Neuroimaging Clin N Am 2010; 20 (4): 511–26. DOI: 10.1016/j.nic.2010.07.004
15. Lemiengre MB, van Driel ML, Merenstein D et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev 2012; 10: CD006089. DOI: 10.1002/14651858.CD006089.pub4
16. Klinicheskie rekomendatsii. Ostryi sinusit. Ministerstvo zdravookhraneniia RF. Natsional'naia meditsinskaia assotsiatsiia otorinolaringologov, 2016. [in Russian]
17. FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Silver Spring, MD: Food and Drug Administration, 2016. http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm
18. Resolution of the Expert Council "Empirical antibacterial therapy of respiratory infections and the risk factors of resistant flora". Handbook for Practitioners Doctors. 2018; 1: 28–32.[in Russian]
Авторы
В.Т.Пальчун1, М.Л.Дербенева*2, А.Л.Гусева1
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ГБУЗ «Городская клиническая больница №1 им. Н.И.Пирогова» Департамента здравоохранения г. Москвы. 117049, Россия, Москва, Ленинский просп., д. 10
*mlderbeneva@mail.ru
1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
2 N.I.Pirogov Clinical Hospital №1 of the Department of Health of Moscow. 117049, Russian Federation, Moscow, Leninskii prosp., d. 10
*mlderbeneva@mail.ru
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ГБУЗ «Городская клиническая больница №1 им. Н.И.Пирогова» Департамента здравоохранения г. Москвы. 117049, Россия, Москва, Ленинский просп., д. 10
*mlderbeneva@mail.ru
________________________________________________
1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
2 N.I.Pirogov Clinical Hospital №1 of the Department of Health of Moscow. 117049, Russian Federation, Moscow, Leninskii prosp., d. 10
*mlderbeneva@mail.ru
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