[Analysis of related factors of recurrent otitis media with effusion in children].
[Analysis of related factors of recurrent otitis media with effusion in children].
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DOI：
10.13201/j.issn.1001-1781.2017.15.007
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发表时间：
2017-08-05
影响因子：
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通讯作者：
Fang, R P
中科院分区：
文献类型：
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作者：
Zhu, Z;Zheng, G X;Fang, R P
目的：探讨儿童渗出性中耳炎反复发作的影响因素。方法：回顾性总结210例渗出性中耳炎患儿的临床资料，治疗后复发75例，痊愈135例，分析复发的相关因素及对症治疗后的效果。结果：Logistic回归分析结果发现腺样体肥大（Ⅲ°、Ⅳ°）、扁桃体肥大(Ⅳ°)与鼻窦炎(包括后鼻孔息肉)、阳性过敏原、上呼吸道感染、胃食管反流、腭裂、年龄较小等对渗出性中耳炎复发有显着影响，有显着性差异(P<0.05)。病程、性别、被动吸烟史及既往渗出性中耳炎病史对渗出性中耳炎的影响无明显统计学意义（P>0.05）。通过不同年龄组间比较，Ⅲ°、Ⅳ°腺样体切除术对>3-6岁组肥大道感染疗效显着（P<0.05），小于3岁组反复呼吸道感染及>3-6岁儿童OME复发组疗效显着（P<0.05）。通过鼓室穿刺或置鼓管，根据不同情况采取对症治疗，共75例（123耳），治愈96耳（78.05%），好转19耳（15.45%），总有效率93.50%，无效8耳（6.50%）。结论：腺样体肥大（Ⅲ°、Ⅳ°），扁桃体肥厚（Ⅳ°）、鼻窦炎、鼻息肉、过敏性疾病及上呼吸道感染、胃食管反流、腭裂以及年龄较小等可能是小儿渗出性中耳炎反复发作的不良因素，临床医生应重视这些症状，根据不同病因，采取个体化治疗方案，使患儿尽快得到最佳治疗。
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.