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对4860名2～12岁急性中耳炎的患儿,单用滴鼻剂和止痛药物治疗,90%以上的患儿可在几天内治愈。仅有2.7%的患儿呈重症表现(3～4天后仍持续性剧痛或高热,或两者兼有),另有20%的患儿耳溢液可持续14天以上。故仅有不足10%的患儿需辅以其它方法治疗。对重症患儿单用抗生素,或用抗生素+鼓膜切开的联合疗法,都比单纯鼓膜切开效果好。但尚不能证实,是否联合治疗优于单纯抗生素疗法。作者对100名重症急性中耳炎患儿的细菌学调查表明,其中30名为A族溶血性链球菌,仅1名为流感嗜血杆菌。这很可能与这些重症患儿的特殊病情有关。因流感嗜血杆菌很少引起疼痛,并能迅速地自然消失。本实验结果尚不能说明病毒在急性中耳炎发病机理中的作用。60例患儿虽
For 4860 children aged 2 to 12 years with acute otitis media, nasal drops and painkillers alone, more than 90% of children can be cured within a few days. Only 2.7% of children presented with severe disease (persistent severe pain or hyperthermia after 3 to 4 days, or both) and an additional 20% of children had an effusion persisting for more than 14 days. Therefore, only less than 10% of children need supplementation with other methods of treatment. For children with severe antibiotics alone or combined with antibiotic + tympanic membrane incision than simple tympanic membrane incision effect. But it can not yet be confirmed whether the combination therapy is better than pure antibiotic therapy. The bacteriological investigation of 100 children with severe acute otitis media showed that 30 of them were Group A hemolytic streptococci and only one was Haemophilus influenzae. This is likely to be related to the special condition of these critically ill children. Haemophilus influenzae rarely causes pain and quickly disappears naturally. The results of this experiment still can not explain the role of the virus in the pathogenesis of acute otitis media. Although 60 cases of children