儿童复发性分泌性中耳炎致病因素meta分析

目的明确儿童复发性分泌性中耳炎(OME)的高危致病因素,为指导复发性OME的治疗提供依据。方法检索英文PubMed、MEDLINE和EMBASE及中文中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库,收集各个数据库建库至2020年5月1日已发表的文献。检索策略:英文检索(pediatric or children)AND(recurrent otitis media with effusion or refractory otitis media with effusion or recurrent OME or refractory OME);中文检索(儿童)AND(复发性分泌性中耳炎OR难治性分泌性中耳炎)。结果共纳入符合检索策略的文献15篇,总研究例数1867例,反复上呼吸道感染合并OR值为4.67(95%CI为2.97~7.36),性别合并OR值为1.18(95%CI为0.80~1.73),吸烟环境合并OR值为0.91(95%CI为0.67~1.22),腭裂合并OR值为3.80(95%CI为2.50~5.79)。结论儿童复发性OME的高危因素主要包括反复上呼吸道感染和腭裂2类。对于有高危因素的复发性OME患儿,建议延长鼓膜置管留置时间至12个月以上,以最大程度降低复发率。

Meta analysis of risk factors of recurrent otitis media with effusion in children

Objective To demonstrate the risk factors of recurrent otitis media with effusion (OME) in children and to provide the theory basis for the treatment of recurrent OME. Methods PubMed, MEDLINE, EMBASE, CNKI, VIP Information and Wanfang data were searched for studies from database building up to May 1 in 2020. Retrieval strategy: pediatric or children) AND (recurrent otitis media with effusion or refractory otitis media with effusion or recurrent OME or refractory OME. Results A total of 1 867 cases of recurrent OME were included in the 15 literatures. The OR of recurrent upper respiratory tract infection was 4.67 (95%CI:2.97~7.36). The OR of sex was 1.18 (95%CI:0.80~1.73). The OR of smoking environment was 0.91(95%CI:0.67~1.22) and the OR of cleft palate was 3.80 (95%CI:2.50~5.79). Conclusions The risk factors of recurrent OME in children mainly include recurrent upper respiratory tract infection and cleft palate. For children with risk factors, it is suggested to extend the indwelling time of tympanic tube for more than 12 months to minimize the recurrence rate of OME.