中耳炎“三段论”分类法的理论和临床研究

Theory and clinical study on “Three-stage Scheme ” of classification of otitis media

研究并提出新的、更科学和更实用的“三段论”中耳炎分类法。方法 复习当代国内外现行的中耳炎分类法 ,分析研究其主要特点和缺陷 ;研究近年与中耳炎分类相关的病理研究新进展 ,提出新的分类法并应用于临床诊治。结果 国内外现行的中耳炎分类法均以临床外显性征象作为分类的主要标准 ,这些征象不能很好地反映中耳腔关键区域重要解剖结构的病变现状和功能受损程度。新提出的“三段论”中耳炎分类法 ,经 1160例中耳炎临床试用 ,其诊断准确率达 82 .4%～ 98.4%。结论 “三段论”中耳炎分类法以当今病理研究成就为科学依据 ,简单实用 。

Objective To propose a new classification scheme of otitis media (OM). Methods By reviewing current internat ional classification systems of OM, we analyzed their disadvantages and the prog ress made in histopathologic studies of OM, then worked out a new classification scheme to apply it to clinic. Results In current internati onal classification systems of OM, those apparent clinical signs are regarded as main standards of classification. Their main disadvantage is that these signs c annot very well indicate the condition of pathologic and functional changes of i mportant hearing structure areas. We proposed a “Three-stage Scheme” of OM cl assification and applied in 1 160 cases of OM. The accuracy rate of diagnosis w as 82.4% in 348 cases of early-stage OM, 98.4% in 696 cases of chronic OM, and 95.2% in 116 cases of OM sequela. Conclusion The “Three-s tage Scheme” system is scientific, simple and practical. Its accuracy rate of d iagnosis is very high. It plays a guiding role in diagnosis and treatment of OM.