长期小剂量克拉霉素治疗儿童慢性分泌性中耳炎的临床观察

目的：观察长期小剂量克拉霉素治疗儿童慢性分泌性中耳炎的疗效。方法：选取本院耳鼻喉门诊2011年3月-2013年9月诊断的28例COME患儿（44耳）,按照随机数字表法将其分为克拉霉素组（24耳）和对照组（20耳）各14例,两组患儿均给予0.5%麻黄素滴鼻液滴鼻、口服黏液促排剂口服1周,克拉霉素组同时口服克拉霉素,疗程为12周;对照组口服阿莫西林,疗程为1周。观察比较两组患儿12周后的治疗效果。结果：治疗12周后,克拉霉素组的有效率75.0%（18/24）明显高于对照组的45.0%（9/20）,差异有统计学意义（P〈0.05）。两组治疗前的平均听阈比较差异无统计学意义（P〉0.05）,而治疗后克拉霉素组的平均听阈（15.6±4.3）dB明显低于对照组的（29.2±7.1）dB,差异有统计学意义（P〈0.01）。结论：长期小剂量口服克拉霉素治疗儿童慢性分泌性中耳炎效果良好,值得临床推广应用。

Clinical Observation of Long-term Low-dose Clarithromycin in the Treatment of Chronic Otitis Media with Effusion in Children

Objective：To observe the curative effect of long term low-dose clarithromycin in the treatment of chronic otitis media with effusion in children.Method：28 children（44 ears） with chronic otitis media with effusion were selected in our Ent outpatient from March 2011 to September 2013,they were randomly divided into the clarithromycin group（24 ears） and the control group（20 ears）,14 cases in each group.Two groups were given 0.5% ephedrine nasal drops or treated with oral mucolytics for one week.The clarithromycin group was given clarithromycin at the same,course of treatment was 12 weeks,the control group was given amoxicillin for one week.The therapeutic effect between the groups was observed and compared after 12 weeks.Result：After 12 weeks of treatment,the effective rate of clarithromycin group was 75.0%（18/24）,it was significantly higher than 45.0%（9/20） of the control group,the difference was statistically significant（P〈0.05）.There was no significant differences in average threshold before treatment between the two groups（P〉0.05）,but after treatment,the average threshold of clarithromycin group was（15.6±4.3）dB,it was significantly lower than（29.2±7.1）dB of the control group,the difference was statistically significant（P〈0.01）.Conclusion：The curative effect of long term low-dose clarithromycin in the treatment of chronic otitis media with effusion in children is good,worthy of clinical popularization and application.