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目的调查腺样体肥大与儿童分泌性中耳炎(SOM)的发生情况,并分析及其影响因素。方法选择2013年1月-2016年6月青岛大学附属妇女儿童医院收治的1 348例腺样体肥大患儿为研究对象,对所有患儿术前均常规进行256Hz声导抗检查,记录鼓室导抗图类型,同时进行鼻咽镜或硬管鼻内镜检查,采用χ~2检验及Logistics回归分析儿童SOM发生率及其影响因素。结果 1 348例腺样体肥大患者中,合并SOM 587例,SOM发生率为43.55%,其中主诉听力下降159例,占11.79%。随着年龄减少,SOM发生率增高,3~5岁患儿发病率最高为69.81%;随着腺样体增生程度增加,SOM发生率增高,腺样体Ⅲ度肥大发生率最高为61.17%;多因素分析显示,3~5岁(OR=3.722,P<0.001)及腺样体Ⅲ度肥大(OR=2.246,P<0.05)是SOM发生的危险因素,而不同性别和不同病程儿童SOM发生率比较,差异无统计学意义(P>0.05)。结论腺样体肥大患儿SOM的发生率较高,腺样体肥大与儿童SOM显著相关,低龄儿童以及腺样体增生程度越高,SOM的发生率越高。
Objective To investigate the incidence of adenoid hypertrophy and secretory otitis media (SOM) in children and analyze its influencing factors. Methods From January 2013 to June 2016, 1 348 adenoid hypertrophy children admitted to the Affiliated Women and Children’s Hospital of Qingdao University were selected as study subjects. All children were routinely given 256 Hz acoustic impedance before operation and recorded tympanic guide Anti-graph type, at the same time nasopharyngeal or endoscopic nasal endoscopy, χ ~ 2 test and Logistics regression analysis of children with SOM incidence and its influencing factors. Results Among 1 348 adenoid hypertrophy cases, 587 cases were complicated with SOM. The incidence of SOM was 43.55%. Among them, 159 cases (11.79%) had hearing loss. With the decrease of age, the incidence of SOM increased, the highest incidence of children aged 3 to 5 years was 69.81%. With the increase of adenoid hyperplasia, the incidence of SOM increased and the incidence of grade Ⅲ hypertrophy was 61.17%. Multivariate analysis showed that SOM occurred at 3 to 5 years (OR = 3.722, P <0.001) and adenoid Ⅲ hypertrophy (OR = 2.246, P <0.05), while SOM occurred in children of different sex and duration There was no significant difference in rates (P> 0.05). Conclusion The incidence of SOM in children with adenoid hypertrophy is higher than that in children with adenoid hypertrophy. The incidence of SOM is higher in younger children and in adenoid hyperplasia.