儿童分泌性中耳炎鼓膜置管术后留置时间与复发的临床研究

发布时间：2018-12-15 16:23

【摘要】：目的:探讨鼓膜置管术后留置时间、取管或脱管后分泌性中耳炎(SOM)复发的影响因素。方法:对465例行鼓膜置管术的SOM患儿的病史以及随访资料进行回顾性分析。结果:随访331例SOM患儿,共576耳,脱管或取管后有177耳(30.73%)复发。置管时平均年龄为(4.69±2.18)岁,3~6岁为高峰。通气管平均留置时间为(9.96±3.72)个月,其中复发耳平均留置时间为(8.59±3.49)个月,痊愈耳为(10.57±3.65)个月,其中留置时间小于6个月者复发率为46.09%。脱管或取管后复发患儿中变应性鼻炎(AR)的患病率为59.62%,高于手术患儿整体患病率(38.67%)。177耳中79耳(44.63%)再次行鼓膜置管术,再次置管患儿的初次通气管平均留置时间为(7.50±3.40)个月,其AR患病率为68.09%,高于痊愈患儿患病率(29.07%)。结论:3~6岁行鼓膜置管术的SOM患儿脱管或取管后易复发,留置时间越短且患有AR的患儿复发率越高。留置时间大于13个月复发率明显降低。
[Abstract]:Objective: to investigate the factors influencing (SOM) recurrence of secretory otitis media after tympanic membrane catheterization. Methods: the history and follow-up data of 465 children with SOM underwent tympanic tube insertion were retrospectively analyzed. Results: a total of 576 ears (576 ears) with SOM were followed up. 177 ears (30.73%) recurred after extubation or extubation. The mean age of catheterization was (4.69 卤2.18) years, and the peak was 3 ~ 6 years old. The mean retention time was (9.96 卤3.72) months. The average retention time of recurrent ears was (8.59 卤3.49) months, and that of cured ears was (10.57 卤3.65) months. The prevalence of allergic rhinitis in children with recurrent rhinitis was 59.62, which was higher than that of children undergoing surgery (38.67%), and 79 ears (44.63%) of 177 ears underwent tympanic membrane tube insertion. The average retention time was (7.50 卤3.40) months, and the prevalence of AR was 68.09, which was higher than that of cured children (29.07%). Conclusion: the recrudescent rate of patients with SOM who underwent tympanic membrane catheterization at 3 or 6 years of age was higher with shorter indwelling time and higher recurrence rate of AR. The recurrence rate of retention time more than 13 months decreased significantly.
【作者单位】：成都市第一人民医院耳鼻咽喉-头颈外科;上海交通大学医学院附属新华医院耳鼻咽喉-头颈外科上海市耳鼻疾病转化医学重点实验室(No:14DZ2260300)上海交通大学医学院耳科学研究所;
【基金】：上海市科委优秀学科带头人计划(No:16XD1402200)
【分类号】：R764.9

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