226Hz和1000Hz鼓室声导纳在不同年龄婴幼儿分泌性中耳炎应用探讨

发布时间：2018-02-20 03:12

本文关键词： 颞骨薄层CT 婴幼儿鼓膜中耳炎积液　出处：《临床耳鼻咽喉头颈外科杂志》2014年10期 　论文类型：期刊论文

【摘要】：目的:以影像学检查为诊断分泌性中耳性的标准,分析不同年龄段分泌性中耳炎常婴幼儿226Hz和1 000Hz 2种探测音鼓室声导纳曲线类型分布特点和趋势,比较2种方法在敏感度和特异度,为临床诊断提供依据。方法:经颞骨薄层CT证实为分泌性中耳炎婴幼儿177例(226耳),中耳结构正常的婴幼儿158例(266耳),年龄1~60个月。根据年龄分为6组,分别为0~6月龄组,6~12月龄组,12~18月龄组,18~24月龄组,24~36月龄组,36~60月龄组,分别进行226Hz和1 000Hz探测音鼓室声导纳测试。用配对χ2检验对不同年龄组受试儿童两种声导纳测试法结果进行检验,并用ROC方法分析2种方法的敏感度和特异度。结果:分泌性中耳炎婴幼儿各组226Hz鼓室声导纳异常检出率分别为21.1%、35.2%、46.9%、42.0%、62.5%及68%,1 000Hz鼓室声导纳异常检出率分别为94.7%、98.1%、96.9%、91.2%、95.8%及88.0%。中耳功能正常婴幼儿,226Hz鼓室声导纳正常型检出率分别为95.1%、88.6%、85.1%、93.3%、88.5%及93.5%,1 000Hz鼓室声导纳正常型检出率分别是为87.8%、94.3%、89.4%、95.6%、94.2%及97.8%。2种测试方法对分泌性中耳炎的检出率在36月龄以下差异有统计学意义,2种测试方法的敏感度和特异度在0~36个月差异有统计学意义,36个月以上差异无统计学意义。结论:36月龄以下婴幼儿探测分泌性中耳炎应以1 000Hz鼓室声导纳为主,36~60月龄幼儿应同时测试226及1 000Hz鼓室声导纳。以单峰型和双峰型1 000Hz鼓室声导纳作为分泌性中耳炎的正常标准,具有很高的可靠性和实用性。
[Abstract]:Objective: to analyze the distribution characteristics and trends of acoustic admittance curves in detecting tympanum of infants and infants with secretory otitis media at 226Hz and 1000 Hz in different age groups by using imaging examination as the criteria for diagnosis of secretory middle ear. The sensitivity and specificity of the two methods were compared. Methods: 177 infants with secretory otitis media and 158 infants with normal middle ear structure, aged 1 to 60 months, were divided into 6 groups according to their age. The age groups were 0 ~ 6 months old group, 12 ~ 12 month old group, 18 ~ 18 month old group, 24 ~ 24 ~ 36 month old group, 36 ~ 60 month old group, respectively. The acoustic admittance tests of 226Hz and 1,000 Hz were carried out respectively. The results of two kinds of acoustic admittance tests in children of different age groups were tested by paired 蠂 2 test. The sensitivity and specificity of the two methods were analyzed by ROC method. Results: the detectable rate of abnormal acoustic admittance in 226Hz tympanic chamber of infants with secretory otitis media was 21.1 ~ 35.29.The detectable rate of abnormal admittance of tympanic chamber was 94.798.196.99.91.29.98% and that of middle ear was 88.00.The detection rate of abnormal admittance in tympanic chamber was 94.798.196.99.99.91.29.Results: the detectable rate of abnormal admittance of tympanic chamber was 94.798.196.99.91.29.85% and that of middle ear was 88.0%, respectively. The positive rates of normal tympanic admittance of normal tympanic motility in infants with normal function were 95.1% and 93.51000 Hz, respectively. The detectable rates of normal tympanic admittance were 87.8% and 93.510Hz, respectively. The detectable rates of secretory otitis media were 87.8% and 97.8.2%, respectively. The detectable rates of secretory otitis media were significantly different under 36 months old. The sensitivity and specificity of the two test methods were significantly different in 0 ~ 36 months, but there was no significant difference in more than 36 months. Conclusion the detection of secretory otitis media in infants under 36 months of age should be guided by 1 000 Hz tympanic sound conduction. The auditory admittance of 226 and 1 000 Hz tympanic acoustic admittance should be tested at the same time. The normal standard of secretory otitis media should be single peak type and double peak type 1 000 Hz tympanic acoustic admittance. It has high reliability and practicability.
【作者单位】：首都医科大学生物医学工程学院;首都医科大学附属北京同仁医院北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学);首都医科大学附属北京同仁医院北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学));
【基金】：北京市卫生系统高层次卫生技术人才培养计划基金(No:2009-3-29) 首都医科大学基础-临床科研合作基金重点项目(No:12JL12) 首都卫生发展科研专项项目(No:2011-1017-01) 资助卫生行业科研专项(No:201202001) 卫生行业科研专项资助项目(No:201202001)
【分类号】：R764.21

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