急性中耳炎的预后。与复发性急性中耳炎发生相关的因素。

Prognosis of acute otitis media. Factors associated with the development of recurrent acute otitis media.

作者信息

Jero J, Karma P

机构信息

Department of Otolaryngology, Helsinki University Central Hospital, Finland.

出版信息

Acta Otolaryngol Suppl. 1997;529:30-3. doi: 10.3109/00016489709124073.

DOI:10.3109/00016489709124073

PMID:9288261

Abstract

Clinical factors associated with the development of recurrent acute otitis media (RAOM) (> or = 3 recurrences during 6 months' follow-up period) after acute otitis media (AOM) were analysed in 121 children aged 3 months to 7 years (median 2 years 6 months). After AOM, 19 (16%) children had primary recurrence (pre-treatment signs and symptoms firstly improved or cured, but worsened or recurred within 30 days' post-treatment) and 33 (27%) developed RAOM during 6 months' follow-up period. It seemed that children < 2 years of age (p = 0.04), children with bilateral disease (p = 0.007), strong infection status (p = 0.05), primary clinical failure (p = 0.04) and development of primary recurrence after AOM (p = 0.001) were significantly related to the development of RAOM in univariate analysis, but only children < 2 years of age (OR 1.5, 95% CI 1.0-5.7, p = 0.04) and the development of primary recurrence (OR 5.1, 95% CI 1.8-14.1, p = 0.002) related to the development of RAOM in multivariate analysis. None of the bacteria cultured from middle ear effusion were related to the development of RAOM.

摘要

对121名年龄在3个月至7岁（中位数为2岁6个月）的儿童进行分析，以探讨急性中耳炎（AOM）后复发性急性中耳炎（RAOM，在6个月随访期内复发≥3次）发生的相关临床因素。AOM后，19名（16%）儿童出现初次复发（治疗前体征和症状最初改善或治愈，但在治疗后30天内恶化或复发），33名（27%）儿童在6个月随访期内发生RAOM。单因素分析显示，年龄<2岁的儿童（p = 0.04）、双侧患病儿童（p = 0.007）、感染状况严重（p = 0.05）、初次临床治疗失败（p = 0.04）以及AOM后出现初次复发（p = 0.001）与RAOM的发生显著相关，但多因素分析显示，仅年龄<2岁的儿童（比值比1.5，95%置信区间1.0 - 5.7，p = 0.04）和初次复发的出现（比值比5.1，95%置信区间1.8 - 14.1，p = 0.002）与RAOM的发生相关。从中耳积液培养出的细菌均与RAOM的发生无关。