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目的探讨儿童分泌性中耳炎(SOM)与腺样体肥大、变应性鼻炎(AR)的相关性及不同治疗方式的临床疗效。方法 348例SOM患儿,按照年龄分为学龄前儿童组(198例)和学龄期儿童组(150例)。分析不同年龄组SOM中腺样体肥大、AR等诱发因素的发病率,并比较合并AR的SOM患儿不同治疗方式的临床疗效。结果学龄前儿童组SOM合并腺样体肥大比例为57.07%,学龄期儿童组SOM合并腺样体肥大的比例为16.67%,两组SOM合并腺样体肥大比例比较差异有统计学意义(P<0.01)。在合并AR的SOM患儿中,常规治疗的临床总有效率58.75%、复发率20.00%,与抗过敏治疗的80.13%、7.05%比较,差异具有统计学意义(P<0.01)。结论腺样体肥大是低年龄组儿童SOM的主要诱发因素,随年龄增长SOM的发生率呈下降趋势;抗过敏治疗能明显提高合并AR的SOM的临床疗效,降低复发率。
Objective To investigate the relationship between secretory otitis media (SOM) and adenoid hypertrophy and allergic rhinitis (AR) in children and the clinical effects of different treatment modalities. Methods 348 children with SOM were divided into preschool children group (198 cases) and school-age children group (150 cases) by age. The incidence of adenoid hypertrophy, AR and other predisposing factors in different age groups was analyzed. The clinical effects of different treatment modalities on SOM with AR were compared. Results The proportion of SOM with adenoid hypertrophy in preschool children was 57.07%. The proportion of SOM with adenoid hypertrophy in school children was 16.67%. There was significant difference in the proportions of SOM with adenoid hypertrophy in both groups (P < 0.01). Among the children with SOM complicated with AR, the total effective rate of conventional treatment was 58.75%, the recurrence rate was 20.00%, which was significantly different from the anti-allergy treatment of 80.13% and 7.05% (P <0.01). Conclusions Adenoid hypertrophy is the major predisposing factor for SOM in children of lower age group. The incidence of SOM decreases with age. Anti-allergy treatment can significantly improve the clinical efficacy and reduce the recurrence rate of SOM with AR.