应用自动咽鼓管吹张器治疗儿童复发性分泌性中耳炎

Role of autoinflation in the treatment of pediatric recurrent otitis media with effusion

目的探讨儿童复发性分泌性中耳炎(otitis Media with Effusion,OME)中咽鼓管功能障碍的病理机制和自动咽鼓管吹张治疗的疗效。方法选择门诊确诊为鼓膜置管术后复发的分泌性中耳炎患儿23例(46耳),评估复发的影响因素,入组患儿随机分为对照组和治疗组,对照组给予鼻用激素、口服粘液促排剂,治疗组在对照组治疗的基础上行自动咽鼓管吹张治疗,入组患儿均治疗4周。结果入组患儿评估影响因素,包括腭裂8例、慢性鼻窦炎5例、变应性鼻炎4例、咽喉反流3例、唐氏综合征3例。对照组有效率50%,治疗组有效率85.71%,后者高于前者,差别有统计学意义(χ~2=6.8931,P<0.05)。结论各种因素引起的咽鼓管功能障碍,是OME鼓膜置管术后复发的重要原因,自动咽鼓管吹张治疗儿童复发性OME有较好短期疗效。

Objective To evaluate the pathogenesis of eustachian tube dysfunction and the curative effect of autoinflation in pediatric recurrent otitis media with effusion（OME）. Methods Twenty-three patients diagnosed with recurrent OME were confirmed,and then they were randomly divided into two groups. Children in the control group were treated with nasal steroid and mucus-diluting agents for 4 weeks. Children in the inflation group received both medicine and autoinflation treatments. Results The risk factors of recurrent OME associated with eustachian tube dysfunction was evaluated,including cleft palates in 8 cases,chronic sinusitis in 5 cases,allergic rhinitis in 4 cases,laryngopharyngeal reflux in 3 cases and Down＇s syndrome in 3 cases. The effectiveness of treatment was 50% in control group and 85.71% in inflation group,and the latter was higher than the former（χ^2=6.8931,P〈0.05）. Conclusion Eustachian tube dysfunction induced by various factors plays an important role in recurrence of OME after grommet insertion. Autoinflation has a good short-term effect in the treatment of pediatric recurrent OME.