目的:探讨腺样体切除术治疗儿童分泌性中耳炎及鼾症的临床疗效。方法:对住院行腺样体切除术的120例分泌性中耳炎及鼾症患儿的临床表现、治疗方法和预后进行回顾性分析。结果:120例患儿经切除肥大的腺样体,辅以相应的药物治疗,临床症状均明显好转。结论:腺样体肥大较易成为儿童分泌性中耳炎及鼾症发病的基础因素。切除肥大的腺样体是治疗儿童分泌性中耳炎及鼾症有效、安全的方法。
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.