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目的:研究婴儿分泌性中耳炎的病程发展特点,为临床观察和治疗提供依据。方法:新生儿听力筛查未通过者,在3月龄内做全面的听力检查,对确诊鼓室积液者进行跟踪随访,每个月复查一次声导抗(226 Hz和1kHz),每3个月完成一次全面的听力复查。将随访至半年以上者纳入研究,共46例,分析影响因素、痊愈时间和病程特点。结果:46例中初筛双耳未通过24例,单耳22例;复筛双耳未通过22例,单耳24例,其中2例单耳未通过者初筛和复筛时的耳别发生了变化;3个月内69耳诊断为分泌性中耳炎(双耳23例,单耳23例),226Hz声导抗(A型、B型或C型)、1kHz声导抗无正峰,DPOAE未引出,ABR反应阈20~60dBnHL。痊愈37例(80.4%),年龄4~18月龄,其中随访半年(9月龄)以内痊愈29例;未愈9例,其中7例在随访半年(7~9月龄)未复诊但电话随访听力好转;另2例病情反复、且由单耳转变为双耳,最终鼓膜置管。影响因素有呛奶、长期鼻塞、反复感冒。结论:婴儿分泌性中耳炎自愈性高,建议适当延长观察等待期,避免及控制影响因素有利于病情痊愈。仅个别病情反复、迁延不愈者方需有创干预。
Objective: To study the characteristics of course of disease of secretory otitis media in infants and provide basis for clinical observation and treatment. Methods: Neonatal hearing screening did not pass, do a comprehensive hearing test within 3 months of age, follow-up of patients diagnosed with tympanic fluid, acoustic impedance (226 Hz and 1kHz), monthly review of every 3 Month to complete a comprehensive hearing review. Follow-up to more than six months were included in the study, a total of 46 cases, analysis of influencing factors, the time of recovery and duration of the disease. Results: In the 46 cases, 24 cases were not examined, 22 cases were single-ear, 22 cases were unselected, 24 cases were single-ear, of which 2 cases were un-passed, 69 cases were diagnosed as otitis media with secretory otitis media (23 cases in both ears and 23 cases in single ear), 226 Hz acoustic impedance (type A, B or C), 1 kHz acoustic impedance without positive peak, DPOAE did not lead, ABR reaction threshold 20 ~ 60dBnHL. Thirty-seven cases (80.4%) were cured and aged from 4 to 18 months, of which 29 cases were cured within 6 months (9 months); 9 cases were unhealed, 7 cases were followed up for 6 months (7-9 months) Follow-up hearing improvement; the other two cases of repeated illness, and from a single ear into the ears, the final tympanic membrane catheterization. Influencing factors are choking, long-term nasal congestion, recurrent cold. Conclusion: Infants with secretory otitis media have high self-healing ability. It is advisable to prolong the observation waiting period and to avoid and control the influencing factors in order to cure the illness. Only a few individual cases of repeated delays in unilateral patients need invasive intervention.