Objective To assess the effectiveness and safety of adenoidectomy on otitis media with effusion (OME) in children. Methods Electronic databases were searched including Medline (1966-2001), EMbase (1974-2001), the Cochrane Controlled Trials Register (CCTR), Chinese Biomedical Database (CBM, 1989-2001). Five Chinese otolaryngology journals were handsearched. References of eligible studies were also screened for inclusion. Selection criteria were restricted to randomized controlled trials comparing adenoidectomy with other treatments in patients with OME in children. At least two reviewers independently assessed trial quality and extracted data. RevMan 4.1 was used for statistical analysis. Results Of the 248 literatures identified, 13 trials with 1 430 patients were eligible and were included in the systematic review. Overall, the methodological quality of the included trials was high, all from developed countries. None of the trials showed that the effects of adenoidectomy better than those of myringotomy and no treatments for OME in children. Four trials comparing adenoidectomy with grommets showed that the effects of grommets were better than those of adenoidectomy. Ten trials described post-surgical bleeding, velopharyngeal incompetence and nasopharyngeal stenosis. Conclusions At present, there is no evidence to either ascertain that adenoidectomy is better than other treatments for OME, or to suggest which type of surgery is the most effective one. Current trials indicate that early administration of adenoidectomy concomitant with grommets might be the most appropriate therapy for OME in children who fail to response to drug treatment, if multiple risk factors exist.
目的 系統評價標準桃金娘油治療分泌性中耳炎的療效及安全性。 方法 電子檢索Cochrane圖書館、PubMed、EMBASE、中國期刊全文數據庫（CNKI）、維普（VIP）、中國生物醫學文獻數據庫（CBM）六大數據庫，檢索時間自建庫截止至2012年2月。根據Cochrane協作網手冊評估納入隨機對照試驗（RCT）的方法學質量，采用RevMan 5.0軟件對數據進行Meta分析。 結果 共納入8個RCT，研究結果顯示，標準桃金娘油聯合常規治療分泌性中耳炎的總有效率優于單用常規治療，但差異無統計學意義[RR=1.21，95% CI（0.98，1.50），P=0.08]。 結論 標準桃金娘油治療分泌性中耳炎有一定療效，但并不顯著。因納入研究質量較低，上述結論還需高質量、大樣本的研究進一步驗證。
【摘要】目的探討鼓膜置管對鼻咽癌(NPC)患者放療前后分泌性中耳炎(SOM)的療效。方法2005年3月2010年1月將60例(84耳)NPC并發SOM患者分為兩組:A組30例行鼓膜切開鼓膜置管;B組30例保守治療為對照組,并行隨訪,對兩組患者有效率和并發癥發生率進行統計。結果60例中58例存活,1例死于全身衰竭,1例死于大出血。存活患者中治療SOM有效率為:A組85.4%(35/41),B組為30.2%(13/43),兩組差異有統計學意義(Plt;0.05);并發癥發生率A組為14.6%(6/41),B組為69.8%(30/43),B組并發癥高于A組,差異有統計學意義(Plt;0.05)。結論NPC患者在放療后,咽鼓管功能受到嚴重損害,是不可逆的病變,鼓膜置管治療NPC并發SOM較保守治療效果好,并發癥的發生率低。
摘要:目的:探討兒童分泌性中耳炎的臨床特點及不同治療方案的效果.方法:回顧性分析84例分泌性中耳炎患兒的臨床資料及其相關因素,并收集資料完整的22例做治療前后的對比。結果:84例患兒中有73.8%存在鼻咽或口咽部病變,另有繼發于感冒占8.33%,伴有先天性聽力障礙占3.65%,例原因不明占總14.29%,鼓膜穿刺并置管同時切除增殖體病變后,聽力顯著提高(Plt;0.05)。結論:對反復發作的SOM患兒應行鼓膜置管,保留6個月以上,同時鼻咽和口咽部伴發病變應引起臨床醫生的重視,積極處理相關疾病。