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儿童耳鼻腔异物——流行病学及其与多动障碍、发育障碍和先天性畸形的相关性

Aural and nasal foreign bodies in children - Epidemiology and correlation with hyperkinetic disorders, developmental disorders and congenital malformations.

作者信息

Schuldt Tobias, Großmann Wilma, Weiss Nora M, Ovari Atilla, Mlynski Robert, Schraven Sebastian P

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany.

Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany.

出版信息

Int J Pediatr Otorhinolaryngol. 2019 Mar;118:165-169. doi: 10.1016/j.ijporl.2019.01.006. Epub 2019 Jan 7.

DOI:10.1016/j.ijporl.2019.01.006
PMID:30639970
Abstract

OBJECTIVES

Foreign body incorporation in children is often a serious situation. Attention deficit hyperactivity disorder (ADHD) could be a risk factor for self-insertion of foreign bodies. Large cohort analyses are missing.

METHODS

This was a retrospective analysis of patients' records from a health insurance company representing 2.19% of the German population and 1.75% of German children and adolescents. According to the International Classification of Diseases, children in the age range between 1 and 18 years have been screened for foreign bodies in ear, nasal sinus and nostrils as well as for hyperkinetic disorders (F90), disorders of psychological development (F80-F89), and congenital malformations, deformations and chromosomal abnormalities (Q00-Q99).

RESULTS

In total, 12887 children (6609 male; 6278 female) have been treated in 16929 cases. The majority (n = 10041 (77.9%)) presented with foreign body incorporation on a single occasion. On average, 1.31 cases of foreign body treatment were recorded per child; 14.1% of children with foreign body treatment (FBT) also had a record of hyperkinetic disorder, 52.7% had a disorder of psychological development, and 50.8% a congenital malformation. Mean occurrence of FBT was 174.8 days before the diagnosis of a hyperkinetic disorder but 517.2 days after the diagnosis of a psychological development disorder and 683.1 days after the diagnosis of a congenital malformation, deformation or chromosomal abnormality.

CONCLUSION

Patients with disorders of psychological development as well as children with congenital malformations are high-risk patients for nasal and aural foreign bodies. The prevalence of a hyperkinetic disorder in patients with FBT is much higher than in the normal population. ADHD is a risk factor for foreign bodies.

摘要

目的

儿童异物嵌入往往是一种严重情况。注意力缺陷多动障碍(ADHD)可能是异物自我插入的一个风险因素。目前尚缺乏大型队列分析。

方法

这是一项对一家健康保险公司患者记录的回顾性分析,该公司覆盖德国人口的2.19%以及德国儿童和青少年的1.75%。根据国际疾病分类,对1至18岁的儿童进行了耳部、鼻窦和鼻孔异物筛查,以及多动障碍(F90)、心理发育障碍(F80 - F89)和先天性畸形、变形及染色体异常(Q00 - Q99)筛查。

结果

总共12887名儿童(6609名男性;6278名女性)接受了16929例治疗。大多数(n = 10041(77.9%))为单次异物嵌入。平均每名儿童记录到1.31例异物治疗;接受异物治疗(FBT)的儿童中,14.1%也有过多动障碍记录,52.7%有心理发育障碍,50.8%有先天性畸形。FBT的平均发生时间在多动障碍诊断前174.8天,但在心理发育障碍诊断后517.2天,在先天性畸形、变形或染色体异常诊断后683.1天。

结论

心理发育障碍患者以及先天性畸形儿童是鼻和耳部异物的高危患者。FBT患者中多动障碍的患病率远高于正常人群。ADHD是异物的一个风险因素。

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