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

An analysis on the relationship between indwelling time after tube insertion and recurrence in children with secretory otitis media

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。

Objective：To analyze the relationship between indwelling time after tube insertion and recurrence after tube removal or extrusion in children with secretory otitis media（SOM）.Method：Medical history and clinical data obtained by follow-up were analyzed in 465 pediatric patients with SOM who underwent tube insertion.Result：（1）331of 465 children were followed up,including 220males（66.47%）,111females（33.53%）,totally 576 ears in which SOM recurred in 177 ears after tube removal or extrusion with the recurrence rate of 30.73%.The average age was（4.69±2.18）years old in children who underwent tube insertion,gathering at age of 3to 6years.The average indwelling time was（9.96±3.72）months for all ears,while（8.59±3.49）months in recurrent ears,and（10.57±3.65）months in healing ears.The recurrence rate was 46.09%in ears in which indwelling time less than 6months.The prevalence of allergic rhinitis in children with recurrent SOM after tube removal or extrusion was 59.62%,which was higher than the overall prevalence rate of 38.67%.（2）Of 177 ears,a second time of the tube insertion was performed in 79ears（44.63%）.The average of the initial indwelling time was（7.50±3.40）months in children with recurrent SOM.The prevalence rate of allergic rhinitis in children who underwent a second time of the tube insertion was 68.09%,which was higher than rate of 29.07%in children cured.Conclusion：SOM was inclined to recur in 3-6year old children.The shorter indwelling time and with allergic rhinitis in children,the higher recurrence rate after tube removal or extrusion.The recurrence rate was significantly lower when indwelling time was more than 13 months.