腺样体肥大儿童分泌性中耳炎发生率及其影响因素分析

目的探讨腺样体肥大儿童分泌性中耳炎(SOM)的发病情况及其影响因素。方法对6 256例住院手术治疗的腺样体肥大儿童进行纤维鼻咽镜或鼻内镜及声导抗检查,对声导抗结果异常的患儿行纯音测听或ABR检查,统计分析不同年龄、不同腺样体肥大程度及不同病程患儿SOM的发生率。结果 6 256例腺样体肥大患儿中合并SOM者2 702例(43.19%,2 702/6 256),而病史中有明确听力减退主诉者仅654例(10.45%,654/6 256);3～5岁年龄段SOM的发生率最高,为69.76%(1 119/1 604),随年龄增长,SOM发生率逐渐下降;Ⅲ°腺样体肥大患儿中SOM发生率为61.73%(1 639/2 655),显著高于Ⅰ度(21.11%,163/772)、Ⅱ度(31.81%,900/2 829)腺样体肥大患儿(P<0.05);不同病程腺样体肥大患儿中SOM发生率差异无统计学意义(P>0.05)。结论本组腺样体肥大患儿SOM发生率为43.19%,低龄和腺样体肥大程度是腺样体肥大患儿并发SOM的影响因素,而病程对其无明显影响。

The Prevalence of Secretory Otitis Media and Influencing Factors in Children with Adenoidal Hypertrophy

Objective To study the prevalence of secretory otitis media and its influencing factors in children with adenoidal hypertrophy. Methods Date of nasopharyngofiberoscopy or nasal endoscopy of the nasopharynx and acoustic immitance were collected from 6256 cases of pediatric adenoidal hypertrophy admitted for surgical treatment.The pure tone audiometry or ABR were obtained in children of secretory otitis media(SOM).The prevalence of secretory otitis media was analyzed in children with adenoidal hypertrophy according to different ages,degrees of adenoidal hypertrophy and course of diseases.Results The results of acoustic immitance data showed that secretory otitis media was confirmed in 2 702cases(43.19%,2 702 / 6 256),although only 654cases(10.45%,654 / 6 256) had audiologic complaints.Peak incidence of otitis media(69.76%,1 119 / 1 604) was at age of 3～5years old along,with the increase of age,the prevalence of SOM was decreased.The prevalence of SOM with Ⅲ°adenoidal hypertrophy was 61.73%(1 639 / 2 655) and much higher than those ofⅠ°(21.11%,163 / 772),Ⅱ°(31.81%,900 / 2 829)(P< 0.05).Disease duration showed no effect on the prevalence(P>0.05).Conclusion The prevalence of secretory otitis media in children with adenoidal hypertrophy was 43.19%.Factors that may increase the chance of secretory otitis media include young age and degrees of adenoidal hypertrophy.The disease duration shows no effect on the prevalence.