探讨儿童分泌性中耳炎的诊断程序  

Diagnostic procedures for pediatric otitis media with effusion

作　　者：刘世琳[1] 刘卫一[1] 王桂香[1] 张亚梅[1] 张杰[1] 孙鹏[1] 姜苏敏[1] 张莉[1] 高军[2] 

机构地区：[1]首都医科大学北京儿童医院耳鼻咽喉科,100045 [2]首都医科大学北京儿童医院影像中心,100045

出　　处：《中华耳鼻咽喉头颈外科杂志》2008年第12期900-902,共3页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：2007年首发基金资助项目（2005-1032）;国家“十一五”科技支撑计划（2007BAI18B12）

摘　　要：目的将鼓室导抗图、纯音听阈与耳CT结果比较，并经鼓膜切开所见验证，分析鼓室导抗图、纯音听阈和耳CT在判断中耳积液的敏感度。方法分析2007年1月至2008年6月临床诊断分泌性中耳炎住院治疗的患者，将其病史、平均听阈、CT结果进行Logistic分析。结果40例（75耳）患者中男28例（53耳），女12例（22耳）。年龄最小3岁6个月，最大11岁10个月，平均6岁6个月。鼓膜切开证实中耳有分泌物62耳（82．7％），无明显分泌物13耳（17．3％）。鼓膜置管23耳。统计学分析结果显示，听力损失程度、CT结果与中耳积液有相关性（r值分别为1．392、1．355；P值均〈0．05）。结论通过鼓膜情况、鼓室导抗图和平均听阈综合判断中耳积液有较高的敏感度。特别以传导性听力损失程度判断有无中耳积液有较高特异性。分泌性中耳炎的患儿，除常规耳科检查，应首先进行声导抗，纯音测听检查。尽管耳CT具有较高的敏感度但是由于其副作用的局限，不建议作为分泌性中耳炎的常规检查。Objective To evaluate the fluid in middle ear of otitis media with effusion （OME） by tympanometry, hearing threshold and in order to an effective and promptly way for treatment. Methods Forty Patients （75 ears） with OME were collected since January 2007 to June 2008. The history of hearing loss, hearing threshold, CT results and the final fluid in the middle ear during operation were analyzed. Results There were 28 males and 12 females enrolled in this study. The average age of the patients was 78 months. All the 75 ears were with type ＂ B＂ according to tympanometry test. For all the patients myringotomy was performed and the ventilation tubes were placed in 23 ears. Among all the ears, there were fluid in 62 ears （82. 7% ） and no fluid in 13 ears （ 17. 3% ）. There was correlation between the levels of hearing loss, CT results and the fluid in middle ear（P 〈 0. 05 ）. Condusions Tympanometry and hearing threshold results should have a better sensitivity and specificity rates for diagnosis of OME.

关 键 词：中耳炎 伴渗出液 声阻抗试验 测听法 纯音 体层摄影术 X线计算机 儿童 

分 类 号：R686[医药卫生—骨科学]