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儿童非胆脂瘤型慢性化脓性中耳炎的药物治疗——两年随访

Medical treatment of chronic suppurative otitis media without cholesteatoma in children--a two-year follow-up.

作者信息

Leiberman A, Fliss D M, Dagan R

机构信息

Department of Otolaryngology, Soroka University Medical Center, Beer-Sheva, Israel.

出版信息

Int J Pediatr Otorhinolaryngol. 1992 Jul;24(1):25-33. doi: 10.1016/0165-5876(92)90063-u.

Abstract

A prospective long-term study was carried out in 48 infants and children with chronic suppurative otitis media without cholesteatoma treated initially with wide spectrum intravenous antibiotics and suction and debridement. Patients were followed for a period of two years. All children were cured after completion of therapy. At 3 and 6 months follow-up 75% of the children were still free of discharge and at 12, 18 and 24 months the proportion of dry ears dropped to 71%, 66% and 52%, respectively. Eighty percent of all recurrences developed already during the first 6 months of follow-up. Pseudomonas aeruginosa was the most common pathogen isolated, both in the initial and recurrent bouts of the disease, and was commonly associated with other pathogens. Children with early reappearance of ear discharge were less likely to benefit from further antimicrobial or surgical treatment. The recurrence rate was not affected by the antibiotic regimen, age, duration of drainage before treatment or the presence of granulation tissue. No intracranial or intratemporal complications were observed during the follow-up period.

摘要

对48例无胆脂瘤的慢性化脓性中耳炎婴幼儿及儿童进行了一项前瞻性长期研究,最初采用广谱静脉抗生素及吸引和清创治疗。对患者进行了为期两年的随访。所有儿童在治疗结束后均治愈。在3个月和6个月随访时,75%的儿童仍无耳漏,在12个月、18个月和24个月时,干耳比例分别降至71%、66%和52%。所有复发中有80%在随访的前6个月内就已出现。铜绿假单胞菌是在疾病的初始发作和复发发作中分离出的最常见病原体,且常与其他病原体相关。耳漏早期复发的儿童从进一步的抗菌或手术治疗中获益的可能性较小。复发率不受抗生素治疗方案、年龄、治疗前引流持续时间或肉芽组织存在情况的影响。随访期间未观察到颅内或颞内并发症。

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