小儿腺样体肥大与分泌性中耳炎

发布时间：2018-10-08 08:44

【摘要】：目的探讨腺样体肥大患儿的不同鼓室图与分泌性中耳炎的关系及分泌性中耳炎的诊断。方法对2009年1月—2011年6月期间本院收治的328例腺样体肥大患儿(包括单纯腺样体肥大及合并有慢性扁桃体炎及扁桃体肥大者)的病例资料进行回顾性分析。分析统计分泌性中耳炎的发病率及声导抗测试诊断分泌性中耳炎的阳性率。结果 328例腺样体肥大患儿中有105例最终经鼓膜穿刺或鼓膜置管确诊为分泌性中耳炎(32.31%);声导抗测试鼓室导抗图表现为B型者89例152耳,其中最终确诊为分泌性中耳炎者为86例147耳,阳性率为96.63%;C导抗图(负压在-150dapa以上)者33例49耳,其中最终确诊为分泌性中耳炎者为16例20耳,阳性率为40.82%;As导抗图2例2耳亦最终确诊为分泌性中耳炎。结论对于腺样体肥大患儿不论主诉有无听力下降,常规进行声导抗测试,同时结合认真的体格检查及电耳镜或耳内镜检查,可大大降低小儿分泌性中耳炎的误诊率。
[Abstract]:Objective to investigate the relationship between tympanogram and secretory otitis media in children with adenoid hypertrophy and the diagnosis of secretory otitis media. Methods from January 2009 to June 2011, 328 children with adenoid hypertrophy (including simple adenoid hypertrophy and chronic tonsillitis and tonsil hypertrophy) were retrospectively analyzed. The incidence of secretory otitis media and the positive rate of acoustic impedance test in diagnosis of secretory otitis media were analyzed. Results among 328 children with adenoid hypertrophy, 105 cases were diagnosed as secretory otitis media by tympanic membrane puncture or tympanic tube insertion (32.31%), and 89 cases (152 ears) showed type B tympanogram by acoustic conductance test. Among them, 86 cases (147 ears) were diagnosed as secretory otitis media, and the positive rate was 96.63% (negative pressure > -150 dapa) in 33 cases (49 ears), of which 16 cases (20 ears) were finally diagnosed as secretory otitis media. The positive rate was 40.82% and 2 ears were diagnosed as secretory otitis media. Conclusion for children with adenoid hypertrophy, the rate of misdiagnosis of secretory otitis media can be greatly reduced by routine acoustic impedance test, combined with careful physical examination and electrootoscopy or endoscopy, regardless of hearing loss in children with adenoid hypertrophy.
【作者单位】：河北大学附属医院耳鼻喉科;河北大学附属医院神经外科;
【分类号】：R764.21

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