摘要
目的探讨借鉴美国儿科学会、家庭医生学会和美国耳鼻咽喉-头颈外科学会《分泌性中耳炎的临床诊断与处理指南》治疗儿童分泌性中耳炎的疗效。方法通过2006年12月至2007年1月对山东省滨州市1536例2～7岁儿童进行分泌性中耳炎横断面流行病学调查,对确诊的96例患儿借鉴该指南进行治疗,即保守治疗随诊3个月,保守治疗3个月无效者选择手术治疗。将拟进行手术的患儿随机分成腺样体切除组及腺样体切除+鼓膜置管组,对2组的疗效进行系统的观察与分析。结果经过系统、规范的随诊、治疗,96例分泌性中耳炎患儿,治愈89例,好转5例,无效2例,有效率97.91%。其中保守治疗有效74例,有效率77.08%;2～3岁、4～5岁、6～7岁三个年龄组经保守治疗有效率差异有统计学意义,年龄越小,保守治疗效果越好。手术治疗22例:腺样体切除术组11例,治愈9例,好转2例,有效率100%;腺样体切除+鼓膜置管组11例,治愈3例,好转6例,无效2例,有效率81.81%;两组有效率差异有统计学意义。结论经过借鉴该指南治疗儿童分泌性中耳炎,有效率高,值得广大耳鼻咽喉科医师参照进行规范治疗。在手术方式选择上推荐腺样体切除术。
Objective To study treatment efficacy in children with otitis media with effusion using the AAP、 AAFP and AAO-HNS guidelines. Methods Between December 2006 and January 2007, 1536 children （aged 2 to 7） in Binzhou City, Shandong Province, were evaluated for possible secretory otitis media., Diagnosis of secretory otitis media was confirmed in 96 of these children, who then received conservative treatments and followed up for 3 months, and additional surgical treatment if the 3 month conservative treatment failed, in accordance to the guidelines. Those who needed surgical intervention were randomly selected to receive adenoidectomy alone or adenoidectomy plus tympanotomy tubes. Results Of the 96 cases, 89 enjoyed complete recovery, 5 showed improvement, and 2 demonstrated no effects, giving a total efficacy rate of 97.91%. In the 74 cases who received conservative treatments, the efficacy rate was 77.08%. When the 2 to 3, 4 to 5, and 6 to 7 years-old age groups were compared, a statistically significant difference was noticed in their response to conservative treatments, suggesting better results with younger age. Of the 11 cases who received adenoidectomy alone, 9 were cured and 2 improved, yielding a 100% efficacy rate. In the 11 cases treated with adenoidectomy plus tympanotomy tubes, 3 were cured, 6 improved and 2 showed no benefits, yielding an efficacy rate of 81.81%, significantly different from those treated with adenoidectomy alone. Conclusion The guidelines seem to result in satisfactory treatment results in children with secretory otitis media and should be adopted by all otolaryngologists involved in treating this patient population. As for surgical management, simple adenoidectomy appears to result in good treatment outcomes
出处
《中华耳科学杂志》
CSCD
2010年第3期319-323,共5页
Chinese Journal of Otology
关键词
儿童
分泌性中耳炎
疗效
Children
Otitis media with effusion
Therapeutic effect
