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幼儿的出生特征与复发性中耳积液

Birth characteristics and recurrent otitis media with effusion in young children.

作者信息

Engel Joost A M, Straetemans Masja, Zielhuis Gerhard A

机构信息

Department of Otorhinolaryngology, Canisius-Wilhelmina Hospital, P.O. Box 9015, 6500 GS Nijmegen, The Netherlands.

出版信息

Int J Pediatr Otorhinolaryngol. 2005 Apr;69(4):533-40. doi: 10.1016/j.ijporl.2004.11.026. Epub 2005 Jan 22.

Abstract

OBJECTIVE

To study the association between birth characteristics and the recurrence of otitis media with effusion (OME).

METHODS

Prospective cohort study on 136 children aged 2-7 years, who received tympanostomy tubes for bilateral otitis media with effusion. Checkups were planned 1 week after tube insertion and once every 3 months thereafter. An otologist examined the ear status to assess tube extrusion and otitis media with effusion recurrence. Outcome measure was the recurrence of otitis media with effusion within 6 months after documentation of spontaneous tube extrusion. Birth characteristics were investigated in relation with the recurrence of otitis media with effusion in 90 children with known clinical outcome.

RESULTS

No statistically significant associations were found between various birth characteristics and the recurrence of otitis media with effusion. Multivariate analyses showed positive but fairly weak associations between recurrence of otitis media with effusion and low birth weight (<2500 g) and/or low gestational age (<37 weeks) and/or a history of incubator care (odds ratio (OR) 1.95, 95% confidence interval (CI): 0.21-18.2), male sex (OR 1.85, 95% CI: 0.56-6.13) and maternal medication use during pregnancy (OR 4.80, 95% CI: 0.57-40.72). A remarkable finding was the asymmetrical distribution of certain birth characteristics within the group of children with recurrence of otitis media with effusion: children with unilateral recurrence had a relatively lower gestational age, lower birth weight, lower 'birth length to birth weight' ratio than the children with bilateral recurrence.

CONCLUSION

These findings suggest that determination of birth characteristics cannot help us in the treatment strategy for recurrent otitis media with effusion in childhood.

摘要

目的

研究出生特征与分泌性中耳炎(OME)复发之间的关联。

方法

对136名2至7岁因双侧分泌性中耳炎接受鼓膜置管术的儿童进行前瞻性队列研究。计划在置管后1周进行检查,此后每3个月检查一次。由耳科医生检查耳部状况,以评估导管脱出和分泌性中耳炎复发情况。观察指标为自发导管脱出记录后6个月内分泌性中耳炎的复发情况。在90名已知临床结局的儿童中,研究出生特征与分泌性中耳炎复发的关系。

结果

未发现各种出生特征与分泌性中耳炎复发之间存在统计学显著关联。多因素分析显示,分泌性中耳炎复发与低出生体重(<2500 g)和/或低孕周(<37周)和/或有保温箱护理史(比值比(OR)1.95,95%置信区间(CI):0.21 - 18.2)、男性性别(OR 1.85,95% CI:0.56 - 6.13)以及母亲孕期用药(OR 4.80,95% CI:0.57 - 40.72)之间存在正向但相当微弱的关联。一个显著发现是,在分泌性中耳炎复发的儿童组中,某些出生特征存在不对称分布:单侧复发的儿童比双侧复发的儿童孕周相对更低、出生体重更低、“出生身长与出生体重”比值更低。

结论

这些发现表明,确定出生特征无助于我们制定儿童复发性分泌性中耳炎的治疗策略。

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