儿童渗出性中耳炎的个体化序列治疗
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摘要
目的探讨儿童渗出性中耳炎(otitis media with effusion,OME)患者的个体化序列治疗效果。方法根据既往治疗渗出性中耳炎的经验,设计一套个体化序列治疗方法。分析我院耳鼻咽喉科2017年3月至2018年6月门诊收治的68例儿童渗出性中耳炎的临床资料和治疗效果。结果过敏性鼻炎(allergic rhinitis,AR)伴渗出性中耳炎38例中,非手术治疗痊愈36例,手术治疗痊愈2例;鼻窦炎(rhinitis)伴渗出性中耳炎12例中,非手术治疗痊愈9例,手术治疗痊愈3例;不伴有过敏性鼻炎或鼻窦炎18例中,非手术治疗痊愈16例,手术治疗痊愈2例。上述7例手术病例中,7例皆行等离子腺样体切除和鼓膜造口引流术,4例同时行双侧扁桃体剥离术。结论个体化序列治疗儿童渗出性中耳炎,不仅临床效果明显,而且大大减少患儿的手术创伤,值得临床推广。
Objective To explore the effect of individualized sequence therapy in children with otitis media with effusion(OME).Methods Based on the experience of previous treatment of OME in children, a set of individualized sequence therapy was designed and applied. The clinical data and therapeutic effect of 68 cases of OME in the outpatient department of Otolaryngology from March2017 to June 2018 were analyzed. Results In 38 cases of allergic rhinitis(AR) with OME,36 cases were cured by non-surgical treatment and 2 cases were cured by surgery; In 12 cases of sinusitis with OME,9 cases were cured by non-surgical treatment and 3 cases were cured by surgery; Among the 18 cases without allergic rhinitis or sinusitis, 16 cases were cured by non-surgical treatment and 2 cases were cured by surgery. Of the above 7 cases of surgery, 7 cases underwent plasma adenoidectomy and tympanostomy, and4 cases underwent bilateral tonsillectomy at the same time. Conclusion Individualized sequence therapy for children with exudative otitis media was effective and safety, which was worthy of clinical promotion.
Objective To explore the effect of individualized sequence therapy in children with otitis media with effusion(OME).Methods Based on the experience of previous treatment of OME in children, a set of individualized sequence therapy was designed and applied. The clinical data and therapeutic effect of 68 cases of OME in the outpatient department of Otolaryngology from March2017 to June 2018 were analyzed. Results In 38 cases of allergic rhinitis(AR) with OME,36 cases were cured by non-surgical treatment and 2 cases were cured by surgery; In 12 cases of sinusitis with OME,9 cases were cured by non-surgical treatment and 3 cases were cured by surgery; Among the 18 cases without allergic rhinitis or sinusitis, 16 cases were cured by non-surgical treatment and 2 cases were cured by surgery. Of the above 7 cases of surgery, 7 cases underwent plasma adenoidectomy and tympanostomy, and4 cases underwent bilateral tonsillectomy at the same time. Conclusion Individualized sequence therapy for children with exudative otitis media was effective and safety, which was worthy of clinical promotion.
引文
1刘娅,杨军,张杰,等.临床实践指南:分泌性中耳炎(更新版)[J].听力学及言语疾病杂志, 2016, 24(5):499-519.
2 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会小儿学组.儿童中耳炎诊断和治疗指南(草案)[J].中华耳鼻咽喉头颈外科杂志,2008, 43(12), 884-885.
3 Bhutta MF, Thornton RB, Kirkham LAS, et al. Understanding the aetiology and resolution of chronic otitis media from animal and human studies[J]. Disease Models&Mechanisms, 2017, 10(11):1289.
4 Ngo CC, Massa HM, Thornton RB, et al. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media:A Systematic Review[J]. Plos One, 2016, 11(3):0150949.
5 Lai D, Qin G, Pu J, et al. Pre-and post-operative application of acoustic rhinometry in children with otitis media with effusion and with or without adenoid hypertrophy-a retrospective analysis[J]. International Journal of Pediatric Otorhinolaryngology, 2017, 103:51.
6 Rovers MM, Schilder AG, Zielhuis GA, et al. Otitis media[J]. Lancet, 2004, 363(9417):465-473.
7 Oh JH, Kim WJ. Interaction Between Allergy and Middle Ear Infection[J]. Current Allergy&Asthma Reports, 2016,16(9):66.
8 杨岫岩.如何合理应用肾上腺皮质激素[J].新医学.2006,(3):194-195.
9 周文娣,张佩斌.维生素D受体及维生素D作用进展[J].中国儿童保健杂志, 2008, 5:560-562.
10 陆伟明. 120例分泌性中耳炎患者的临床治疗效果分析[J].中国现代医生, 2011, 8:141-142.
11 Bergman P. Can vitamin D supplementation prevent chronic otitis media with effusion[J]. Acta Paediatrica,2017, 106(9):1385-1386.
12 Buzatto GP, Tamashiro E, Proenca-Modena JL, et al. The pathogens profile in children with otitis media with effusion and adenoid hypertrophy[J]. Plos One, 2017, 12(2):e0171049.
13 韦懿.儿童分泌性中耳炎53例临床治疗体会[J].临床合理用药杂志, 2011, 4(7A):149.
14 宋喜.试论儿童鼻窦炎规范化诊断和治疗[J].中国医学工程, 2013, 11:186-187.
15 Song W, Zhang Y, Wang J, et al. Antagonism of cysteinyl leukotriene receptor 1(cys LTR1)by montelukast suppresses cell senescence of chondrocytes[J]. Cytokine,2018, 103:83-89.
2 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会小儿学组.儿童中耳炎诊断和治疗指南(草案)[J].中华耳鼻咽喉头颈外科杂志,2008, 43(12), 884-885.
3 Bhutta MF, Thornton RB, Kirkham LAS, et al. Understanding the aetiology and resolution of chronic otitis media from animal and human studies[J]. Disease Models&Mechanisms, 2017, 10(11):1289.
4 Ngo CC, Massa HM, Thornton RB, et al. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media:A Systematic Review[J]. Plos One, 2016, 11(3):0150949.
5 Lai D, Qin G, Pu J, et al. Pre-and post-operative application of acoustic rhinometry in children with otitis media with effusion and with or without adenoid hypertrophy-a retrospective analysis[J]. International Journal of Pediatric Otorhinolaryngology, 2017, 103:51.
6 Rovers MM, Schilder AG, Zielhuis GA, et al. Otitis media[J]. Lancet, 2004, 363(9417):465-473.
7 Oh JH, Kim WJ. Interaction Between Allergy and Middle Ear Infection[J]. Current Allergy&Asthma Reports, 2016,16(9):66.
8 杨岫岩.如何合理应用肾上腺皮质激素[J].新医学.2006,(3):194-195.
9 周文娣,张佩斌.维生素D受体及维生素D作用进展[J].中国儿童保健杂志, 2008, 5:560-562.
10 陆伟明. 120例分泌性中耳炎患者的临床治疗效果分析[J].中国现代医生, 2011, 8:141-142.
11 Bergman P. Can vitamin D supplementation prevent chronic otitis media with effusion[J]. Acta Paediatrica,2017, 106(9):1385-1386.
12 Buzatto GP, Tamashiro E, Proenca-Modena JL, et al. The pathogens profile in children with otitis media with effusion and adenoid hypertrophy[J]. Plos One, 2017, 12(2):e0171049.
13 韦懿.儿童分泌性中耳炎53例临床治疗体会[J].临床合理用药杂志, 2011, 4(7A):149.
14 宋喜.试论儿童鼻窦炎规范化诊断和治疗[J].中国医学工程, 2013, 11:186-187.
15 Song W, Zhang Y, Wang J, et al. Antagonism of cysteinyl leukotriene receptor 1(cys LTR1)by montelukast suppresses cell senescence of chondrocytes[J]. Cytokine,2018, 103:83-89.