LACK OF SPECIFIC SYMPTOMATOLOGY IN CHILDREN WITH ACUTE OTITIS-MEDIA
LACK OF SPECIFIC SYMPTOMATOLOGY IN CHILDREN WITH ACUTE OTITIS-MEDIA
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DOI：
10.1097/00006454-199409000-00002
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发表时间：
1994-09-01
影响因子：
3.6
通讯作者：
ALHO, OP
中科院分区：
文献类型：
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作者：
NIEMELA, M;UHARI, M;ALHO, OP
虽然急性病患儿的症状在急性中耳炎（AOM）的诊断和随访中都很重要，但有关这些症状的数据非常有限。我们进行了一项前瞻性调查，收集了354名连续的儿童访问儿科医生，耳鼻喉科医生或全科医生，因为任何一种急性症状，比较儿童急性中耳炎的症状与其他急性传染病的儿童。在家庭中观察到的症状和体征由父母在访视前记录，体格检查结果随后由医生记录。191例患者（54.0%）被诊断为AOM。与AOM相关的主要症状是耳痛（相对危险度（RR）5.4; P < 0.001）、摩擦耳朵（RR 5.0：P < 0.001）和耳朵阻塞感（RR 4.5; P < 0.05）。然而，只有67.7%的2岁以下AOM儿童有任何与耳相关的症状。有鼓膜造孔管的儿童有耳痛（47.8%）和摩擦耳朵（58.8%）的程度与没有管的儿童相同。鼻炎增加了AOM的可能性（RR 2.3; P < 0.001），2岁以上儿童过度哭泣也增加了AOM的可能性（RR 3.0; P < 0.001）。90.1%的AOM患者出现发热、耳痛或过度哭闹，而72.4%的非AOM患者也出现发热、耳痛或过度哭闹。许多以前被认为与AOM有关的症状，如发热、咳嗽、食欲不振、腹泻和呕吐，在AOM儿童中并不比其他急性疾病儿童更常见。与其他急性诊断的儿童相比，AOM儿童的任何症状的持续时间均无显著差异。我们的结论是，AOM不会引起任何特定的症状，父母可以使用他们的决定，寻求医疗建议，为他们的孩子。
Although the symptoms of the acutely ill child are important both in the diagnosis and follow-up of acute otitis media (AOM), data about them are quite limited. We carried out a prospective survey by collecting information on 354 consecutive children visiting a pediatrician, otolaryngologist or general practitioner because of any kind of acute symptoms to compare symptoms of children with acute otitis media with those of children with other acute infectious diseases. The symptoms and signs observed at home were recorded by the parents before the visit and the findings in the physical examination were recorded later by the physician. AOM was diagnosed in 191 patients (54.0%). The most important symptoms increasing the likelihood of AOM significantly were ear-related symptoms, such as earache (relative risk (RR) 5.4; P < 0.001), rubbing of the ear (RR 5.0: P < 0.001) and feeling of blocked ear (RR 4.5; P < 0.05). However, only 67.7% of children younger than 2 years of age with AOM had any ear-related symptoms. The children with tympanostomy tubes had earache (47.8%) and rubbing of the ear (58.8%) of the same magnitude as did children without tubes. Rhinitis increased the likelihood of AOM (RR 2.3; P < 0.001) as did excessive crying in children older than 2 years of age (RR 3.0; P < 0.001). Fever, earache or excessive crying was present in 90.1% of patients with AOM but also in 72.4% of patients without AOM. Many symptoms previously thought to be related to AOM, such as fever, cough, poor appetite, diarrhea and vomiting, were not more common in children with AOM than in children with other acute illnesses. The duration of any of the symptoms was not markedly different in children with AOM than in children with other acute diagnoses. We conclude that AOM does not cause any specific symptoms that parents could use in their decision to seek medical advice for their child.