儿童反复发作分泌性中耳炎的临床分析

朱珠; 郑国玺; 李琦; 石秋兰; 周洪根; 方如平

doi:10.13201/j.issn.1001-1781.2017.15.007

儿童反复发作分泌性中耳炎的临床分析

- 1. 南京医科大学附属儿童医院耳鼻咽喉科(南京, 210008);
- 2. 西安交通大学第二附属医院耳鼻咽喉头颈外科病院
基金项目:
国家自然科学基金资助项目（No：81271068）；高等学校博士学科点专项科研基金资助项目（No：20120201110060）；南京市医学科技发展专项资金资助项目（No：YKK13134）；南京医科大学科技发展基金资助项目（No：2012NJMU059）

详细信息

通讯作者: 朱珠,E-mail:zhuzhu.hx@tom.com

中图分类号: R764.21

收稿日期: 2017-03-01

Analysis of related factors of recurrent otitis media with effusion in children

- 1. Department of Otorhinolaryngology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China;
- 2. Department of Otorhinolaryngology, Second Hospital of Xi'an jiaotong University

More Information

Corresponding author: ZHU Zhu, E-mail: zhuzhu.hx@tom.com

Received Date: 01 March 2017

摘要

摘要: 目的：探讨儿童分泌性中耳炎（OME）反复发作的相关影响因素。方法：回顾性总结210例OME患儿的临床资料，其中75例经治疗后复发，未复发者135例，对其相关复发因素及对症治疗后疗效进行分析。结果：Logistic回归分析结果发现腺样体肥大（Ⅲ度、Ⅳ度）、扁桃体肥大（Ⅳ度）、鼻窦炎（包括后鼻孔息肉）、变应性鼻炎、上呼吸道感染、胃食管反流、腭裂、小年龄对OME的复发有显著影响，差异均有统计学意义（P<0.05）；而病程、性别、既往中耳炎病史、被动吸烟史对OME复发的影响无统计学意义（P>0.05）。不同年龄组之间比较，腺样体Ⅲ度、Ⅳ度肥大对>3~6岁儿童OME复发的影响有显著意义（P<0.05），反复呼吸道感染对 ≤ 3岁组和>3~6岁组儿童OME的复发有显著影响（P<0.05）。采用鼓膜切开或置管并根据不同的病情采取对症治疗， 75例（123耳）患儿治愈96耳（78.05%），好转19 耳（15.45%），总有效率为93.50%，无效8 耳（6.50%）。结论：腺样体肥大（Ⅲ度、Ⅳ度）、扁桃体肥大（Ⅳ度）、鼻窦炎、鼻息肉、变态反应疾病、上呼吸道感染、胃食管反流、腭裂以及年龄较小可能是复发型儿童OME的相关因素，应引起临床医生的重视。针对不同的病因，对OME患儿采用个体化的治疗方案，使患儿尽早得到最佳治疗。
- 中耳炎,分泌性 /
- 儿童 /
- 复发 /
- 腺样体肥大 /
- 鼻窦炎
Abstract: Objective: To investigate the influencing factors of recurrent episodes of otitis media with effusion in children.Method: A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed.Result: Logistic regression analysis results found that adenoid hypertrophy(Ⅲ°,Ⅳ°), tonsil hypertrophy(Ⅳ°) and sinusitis(including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference(P<0.05); And the influence of duration,gender,passive smoking history and previous medical history of otitis media with effusion has no obvious statistical significance(P>0.05). Through the comparison among different age groups, adenoidectomy Ⅲ °, Ⅳ ° hypertrophy tract infections in >3-6 years old group has significant effect (P<0.05), recurrent respiratory tract infections in less than 3 years old group and the group of children aged >3-6 years OME recurrence has significant effect(P<0.05). By tympanocentesis or tympanostomy tube insertion and according to different conditions to take symptomatic treatment, 75 cases(123 ears) were cured 96 ears(78.05%), 19 ears were improved(15.45%), the total effective rate was 93.50%, ineffective in 8 ears(6.50%).Conclusion: Adenoid hypertrophy(Ⅲ°,Ⅳ°), tonsil hypertrophy(Ⅳ°), sinusitis, nasal polyps, allergic diseases and upper respiratory tract infection gastroesophageal reflux, cleft palate and younger age may be adverse factors related to recurrent otitis media with effusion in children, the clinical doctors should pay attention to these symptoms, according to different causes, adopt individualized treatment plan, make children get the best treatment as soon as possible.
- otitis media,secretory /
- child /
- recurrence /
- adenoid hypertrophy /
- sinusitis

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