Lous Jørgen, Ryborg Christina T, Thomsen Janus L
Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Denmark.
Int J Pediatr Otorhinolaryngol. 2011 Sep;75(9):1058-61. doi: 10.1016/j.ijporl.2011.05.009. Epub 2011 Jun 2.
Documentation of the effect of tympanostomy tubes in children with recurrent acute otitis media (RAOM) is limited. A recently published Cochrane review on the effect of tympanostomy tubes in children with RAOM was based on only two studies. Could the documentation be increased by including other randomized studies?
A MEDLINE and EMBASE search for randomized controlled trials was performed and 143 eligible papers were found. Only five studies could be included. All five were randomized studies with a total of 519 children, four randomized by children and one by ears. All five studies had different designs and control groups, making a proper meta-analysis impossible. Three studies had an antibiotic treated group, two studies a placebo group, and two studies a no treatment group as comparison group. Outcome measures were rates of AOM or fraction free of AOM in six or 12 months.
Between two and five children have to be treated with tympanostomy tubes to prevent one child from attacks of acute otitis media (AOM) in six months. Tube treatment could reduce AOM with about one attack in six months after operation. Six months treatment with antibiotics was not different from treatment with tubes. No study reported quality of life for child and family or parental absence from day care or work.
Insertion of tympanostomy tubes or long-term treatment with antibiotics seems to prevent one attack of AOM or keep one child out of three free from AOM in six months.
关于鼓膜置管术对复发性急性中耳炎（RAOM）患儿疗效的文献资料有限。最近发表的一篇关于鼓膜置管术对RAOM患儿疗效的Cochrane综述仅基于两项研究。纳入其他随机研究能否增加相关文献资料？
检索MEDLINE和EMBASE数据库以查找随机对照试验，共找到143篇符合条件的论文。仅5项研究可被纳入。这5项均为随机研究，共涉及519名儿童，其中4项按儿童随机分组，1项按耳朵随机分组。所有5项研究的设计和对照组均不同，因此无法进行恰当的荟萃分析。3项研究有抗生素治疗组，2项研究有安慰剂组，2项研究有无治疗组作为对照组。观察指标为6个月或12个月时的急性中耳炎（AOM）发病率或无AOM的比例。
在6个月内，必须对2至5名儿童进行鼓膜置管术治疗，才能预防1名儿童发生急性中耳炎（AOM）发作。置管治疗可使术后6个月内AOM发作次数减少约1次。6个月的抗生素治疗与置管治疗效果无差异。没有研究报告儿童及其家庭的生活质量或父母缺勤日托或工作的情况。
鼓膜置管术或长期抗生素治疗似乎可预防1次AOM发作，或使每3名儿童中有1名在6个月内不患AOM。
