学龄前儿童分泌性中耳炎的早期诊断

Early Diagnosis of Otitis Media with Effusion in Preschool Children

目的探讨提高学龄前儿童分泌性中耳炎早期诊断的有效方法。方法回顾分析我科门诊169例338耳,以鼻-鼻窦炎和鼾症症状为主述(家长代述)但未发现听力障碍就诊的学龄前儿童,经询问病史、专科体查及声导抗测试,确诊为分泌性中耳炎的临床资料。依病因分为鼻-鼻窦炎、鼾症和鼻-鼻窦炎并鼾症三组,分析各组分泌性中耳炎患耳率并与对照组比较。结果鼻-鼻窦炎、鼾症、鼻-鼻窦炎并鼾症及对照组分泌性中耳炎患耳率分别为:55.96%、48.08%、63.24%、11.19%,经卡方检验前三组与对照组间比较患耳率差异有统计学意义(P<0.001),而前三组间患耳率差异无统计学意义(P>0.05)。结论学龄前儿童是分泌性中耳炎的高危人群,发病有隐袭性特点,鼻-鼻窦炎、鼾症是主要病因。经详细询问病史、仔细的专科体查及简便易行的声导抗测试即可明确诊断,应引起家长、老师和医务人员的高度重视,以免延误早期诊治。

Objective To investigate efficient examination for early diagnosis of otitis meida woth effusion in preschool children. Methods 169 cases（ 338 ears） with otitis media effusion in preschool children in our clinic were analyzed.All the data were analyzed retrospectively. All the pediatric patients complained symptoms related to rhinosinusitis and pediatric snoring while they had not been found hearing impairment. All the pediatric patients were diagnosed due to the history,special physical examination and acoustic impedance. And all the patients were divided into 3 groups： group 1 with rhinosinusitis,group 2 with pediatric snoring,and group 3 with rhinosinusitis and pediatric snoring. The incidence rates of otitis media with effusion were analyzed among the three groups and control group. Results The incidence rates for group1,group2,group 3 and contrl group were 55. 96% 、48. 08% 、63. 24% 、11. 19% respectively. According to χ^2 test,there were significant difference between group 3 and control group（ P〈0.001）,respectively. But there was no difference among the three experimental groups（ P〉0.05）. Conclusion Preschool children are high- risk population,which are attacked by otitis media with effusion. The primary factors include rhinosinusitis and pediatric snoring. Detailed history,careful special physical examination and acoustic impedance are most useful for diagnosis. All the parents,kindergareners and physicians should pay attention to early symptoms,otherwise early diagnosis and early treatment will be missed.