儿童分泌性中耳炎耳内镜下鼓室置管术后复发因素分析  

Recurrence factors after endoscopic femoral entricular catheter placement in children with secretory otitis media

作　　者：敬云龙[1] 黄敏[1] 李赟[1] 谢江 赵伟亮 胡彬雅[1] Jing Yunlong;Huang Min;Li Yun;Xie Jiang;Zhao Weiliang;Hu Binya(Department of Otorhinolaryngology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院耳鼻咽喉头颈外科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2021年第7期652-657,共6页Journal of Clinical Pediatric Surgery

基　　金：湖南省儿童医院1233人才工程资助。

摘　　要：目的探讨儿童分泌性中耳炎耳内镜下鼓室置管术后复发的相关因素。方法回顾性分析2017年3月至2018年3月于湖南省儿童医院实施儿童分泌性中耳炎耳内镜下鼓室置管手术的93例患者资料,随访1年,根据复发情况分为复发组(n=23)和未复发组(n=70)。收集患者病程、性别、年龄、吸烟环境、扁桃体炎症、反复呼吸道感染、变应性鼻炎、乳突气化不良、通气管保留时间、慢性鼻窦炎及腺样体肥大或鼻咽部淋巴组织增生等资料,分析术后复发的危险因素。结果所有患者完成随访,术后23例(24.73%)复发,平均复发时间为术后(9.56±1.56)个月;单因素分析结果显示,两组患者病程、性别、年龄、吸烟环境、扁桃体炎症差异无统计学意义(P>0.05);反复呼吸道感染、变应性鼻炎、乳突气化不良、通气管保留时间、慢性鼻窦炎及腺样体肥大或鼻咽部淋巴组织增生与术后复发相关(P<0.05);多因素非条件Logistic分析发现反复呼吸道感染(OR=2.317,95%CI:1.381~3.227)、变应性鼻炎(OR=1.892,95%CI:1.519~3.028)、乳突气化不良(OR=0.723,95%CI:0.386~0.898)、通气管保留时间(OR=1.225,95%CI:0.882~1.897)、慢性鼻窦炎(OR=1.622,95%CI:1.072~2.438)及腺样体肥大或鼻咽部淋巴组织增生(OR=1.187,95%CI:0.825~1.713)是导致儿童分泌性中耳炎耳内镜下鼓室置管术后复发的独立危险因素(P<0.05)。结论患者反复呼吸道感染、变应性鼻炎、乳突气化不良、通气管保留时间、慢性鼻窦炎及腺样体肥大或鼻咽部淋巴组织增生是儿童分泌性中耳炎内镜下鼓室置管术后复发的危险因素,临床上对于具有复发危险因素的患者应加以重视,提高治疗效果。Objective To explore the recurrence factors after endoscopic femoral entricular catheter placement in children with secretory otitis media.Methods Retrospective analysis was performed for the pathological data of 93 children undergoing endoscopic femoral catheterization for secretory otitis media from March 2017 to March 2018.Based upon follow-up visits,they were divided into observation group(n=23)and non-recurrent control group(n=70).The course of disease,gender,age,smoking environment,tonsil inflammation,recurrent respiratory tract infection,allergic rhinitis,poor mastoid gasification,ventilation duration,chronic sinusitis,adenoid hypertrophy or nasopharyngeal lymphoproliferative tissue and other data were collected for analyzing the risk factors for postoperative recurrence.Results During follow-ups,23 children(24.73%)had postoperative recurrence with a mean recurrence time of(9.56±1.56)months.Univariate analysis revealed no significant inter-group differences in disease course,gender,age,smoking environment or tonsillitis(P>0.05).Recurrent respiratory tract infection,allergic rhinitis,poor mastoid gasification,ventilation tube retention time,chronic sinusitis and adenoid hypertrophy or nasopharyngeal lymphoid tissue hyperplasia were associated with postoperative recurrence(P<0.05).Recurrence was taken as a dependent variable and multivariate unconditional Logistic analysis was performed.Recurrent respiratory tract infection(OR=2.317,95%CI:1.381-3.227),allergic rhinitis(OR=1.892,95%CI:1.519-3.028),poor mastoid gasification(OR=0.723,95%CI:0.386-0.898),airway retention time(OR=1.225,95%CI:0.882-1.897),chronic sinusitis(OR=1.622,95%CI:1.072-2.438)and adenoid hypertrophy or nasopharyngeal lymphoid tissue hyperplasia(OR=1.187,95%CI:0.825-1.713)were independent risk factors for a recurrence of pediatric secretory otitis media after endoscopic tympanoplasty(P<0.05).Conclusion Children with recurrent respiratory tract infection,allergic rhinitis,poor mastoid gasification,ventilation tube retention time,chronic sinus

关 键 词：分泌性中耳炎 耳内镜下鼓室置管术 术后复发 危险因素 儿童 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R764.9[医药卫生—临床医学]