婴儿分泌性中耳炎的随访分析

发布时间：2018-07-26 11:10

【摘要】：目的:研究婴儿分泌性中耳炎的病程发展特点,为临床观察和治疗提供依据。方法:新生儿听力筛查未通过者,在3月龄内做全面的听力检查,对确诊鼓室积液者进行跟踪随访,每个月复查一次声导抗(226 Hz和1kHz),每3个月完成一次全面的听力复查。将随访至半年以上者纳入研究,共46例,分析影响因素、痊愈时间和病程特点。结果:46例中初筛双耳未通过24例,单耳22例;复筛双耳未通过22例,单耳24例,其中2例单耳未通过者初筛和复筛时的耳别发生了变化;3个月内69耳诊断为分泌性中耳炎(双耳23例,单耳23例),226Hz声导抗(A型、B型或C型)、1kHz声导抗无正峰,DPOAE未引出,ABR反应阈20~60dBnHL。痊愈37例(80.4%),年龄4~18月龄,其中随访半年(9月龄)以内痊愈29例;未愈9例,其中7例在随访半年(7~9月龄)未复诊但电话随访听力好转;另2例病情反复、且由单耳转变为双耳,最终鼓膜置管。影响因素有呛奶、长期鼻塞、反复感冒。结论:婴儿分泌性中耳炎自愈性高,建议适当延长观察等待期,避免及控制影响因素有利于病情痊愈。仅个别病情反复、迁延不愈者方需有创干预。
[Abstract]:Objective: to study the developmental characteristics of secretory otitis media in infants and to provide evidence for clinical observation and treatment. Methods: the newborns who had not passed the screening of hearing were examined by comprehensive hearing examination within 3 months of age. The patients with confirmed tympanic effusion were followed up. The acoustic conductance (226Hz and 1kHz) was rechecked once a month, and the hearing reexamination was completed every 3 months. A total of 46 patients were followed up to more than half a year. The influencing factors, recovery time and course of disease were analyzed. Results of 46 cases, 24 cases were not passed through the primary sieve ears, 22 cases were single ears, 22 cases were double ethmoidal ears, 24 cases were single ears. In 2 cases of monaural failure, the first screen and the second sieve changed, and within 3 months 69 ears were diagnosed as secretory otitis media (23 cases of binaural, 23 cases of monaural) with 226Hz acoustic impedance (type A, type B or C) without positive peak DPOAE, and no positive peak of ABR response threshold of 2060dBnHL was found in 69 ears. 37 cases (80.4%) were cured, the age was 4 ~ 18 months old, 29 cases were cured within half a year (9 months old) followed up, 9 cases were not recovered, 7 cases were not followed up for six months (7 ~ 9 months old) but the hearing was improved by telephone, and the other 2 cases had repeated condition and changed from one ear to two ears. Finally, tympanic membrane tube. Affecting factors are choking milk, long-term nasal congestion, repeated colds. Conclusion: the recovery of secretory otitis media in infants is high. It is suggested that the observation waiting period should be lengthened and the influence factors should be avoided and controlled. Only individual disease is repeated, delay does not heal only then need to have invasive intervention.
【作者单位】：华中科技大学同济医学院附属武汉儿童医院耳鼻喉科;
【基金】：武汉市卫计委科技基金项目(No:WX16C15)
【分类号】：R764.21

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