难治性分泌性中耳炎危险因素分析  

Risk Factors for Refractory Secretory Otitis Media

作　　者：冯晓华[1] 龙孝斌[2] 汪建[1] 陈勇挺[1] 

机构地区：[1]广州军区广州总医院耳鼻咽喉科,广州510010 [2]南方医科大学珠江医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2013年第5期486-489,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨难治性分泌性中耳炎的危险致病因素。方法回顾性分析2003年6月-2011年6月收治的难治性分泌性中耳炎患者42例(56耳,病例组)和50例(66耳)非难治性分泌性中耳炎患者(对照组)的临床资料,对两组患者的病程、上呼吸道感染、咽鼓管功能障碍、慢性鼻窦炎、鼻中隔偏曲、鼻咽部恶性肿瘤、扁桃体炎症、腺样体肥大、变应性鼻炎、乳突气化不良、年龄、性别、急性中耳炎治疗不当、腭裂、中耳气压损伤等15种因素进行危险因素统计学分析比较。结果 15种相关因素中,两组患者的病程(χ2=9.814,P<0.01)、乳突气化不良(χ2=15.301,P<0.01)、变应性鼻炎(χ2=32.614,P<0.01)相比较,差异有统计学意义;乳突气化不良患者难治性分泌性中耳炎发生率是乳突气化良好患者的4.164倍(95%CI:1.903-9.112),变应性鼻炎患者难治性分泌性中耳炎发生率为无变应性鼻炎者的17.192倍(95%CI:5.850-50.524)。结论乳突气化不良及变应性鼻炎可能是难治性分泌性中耳炎的致病危险因素。Objective To identify the risk factors of refractory secretory otitis and analyse the results. Methods The study subjects were 42 patients（56 ears） with secretory secretory otitis media from June 2003 to June 2011, all patients were performed with ears, nose, pharynx and throat routine inspection and mastoid HRCT. All patients were retrospectively analyzed possible risk factors： suchas history, infection, eustachian tube dysfunction, chronic sinusitis, deflection of nasal septum, nose pharynx ministry malignant tumor, tonsillitis, adenoid hypertrophy, allergic rhinitis, etc. Results In the multivariate analysis of 42 patients（56 ears） with refractory secretory otitis media and the control group of 50 patients（66 ears）, statistically significant in the history （X2= 9. 814,P〈2 0.01）, mastoid pneumatization adverse （X2 =15. 301,P〈0.01）, and allergic rhinitis （X2= 32. 614,P〈0.01）were observed. Two of them were found to be significant in the logistic regression model： mastoid pneumatization adverse （OR=4.44）, and allergic rhinitis（OR = 15.13）. Patients of mastoid pneumatization adverse with refractory otitis media is 4. 164 times （95% CI, 1. 903 -9. 112） ; patients of allergic rhinitis was 17. 192 times higher than that of in no allergic patients （95G CI, 5. 850 - 50. 524）. Conclusion Mastoid pneumatization adverse and allergic rhinitis are the risk factors for refractory secretory otitis media.

关 键 词：中耳炎 分泌性 难治性 危险因素 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]