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МЕСТО ТОПИЧЕСКОЙ СТЕРОИДНОЙ ТЕРАПИИ В ЛЕЧЕНИИ ОСТРОГО РИНОСИНУСИТА

https://doi.org/10.21518/2079-701X-2017-16-18-23

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Аннотация

Острый риносинусит – это распространенное воспаление носа и околоносовых пазух. Диагноз «синусит» основывается на сочетании клинических  данных с осмотром, данными инструментальных  исследований. На вирусные ОРС  приходится свыше 90% случаев заболевания. Бактериальная этиология синусита имеет место примерно в 55–65%  случаев. Целью лечения острого РС является ликвидация очага инфекции, восстановление пассажа в области остиомеатального комплекса, налаживание дренажной функции, уменьшение воспаления и облегчение симптомов, таких как боль и заложенность носа. Основными направлениями  лечения являются антибактериальная  терапия, ирригация, противовоспалительная  терапия. Топические кортикостероиды – препараты первой линии, наряду с ирригацией.  Они могут использоваться  как в качестве монотерапии, так и в дополнение к антибактериальной  терапии. При легких формах ОРС мометазон в дозе  400  мкг/сут оказался значительно более эффективным, чем плацебо и амоксициллин. А добавление топических кортикостероидов (МФ) к стандартному курсу системной антибиотикотерапии  (амоксициллин/клавуланат, цефуроксим) значительно быстрее по сравнению с плацебо облегчало симптомы острого РС и ускоряло выздоровление. Интраназальные стероиды помогают в лечении дневного кашля. При сравнении  с лечением другими ИГКС мометазон обладает большей эффективностью, безопасностью, лучшим разрешением симптомов, меньшей стоимостью лечения. Мометазон может использоваться беременными женщинами без опасения системных проявлений.

Об авторах

С. Я. Косяков
Российская медицинская академия непрерывного профессионального образования
Россия

Доктор медицинских наук,  профессор.

Москва



Ю. В. Минавнина
Российская медицинская академия непрерывного профессионального образования
Россия

Москва



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