【摘要】 目的探讨分泌性中耳炎(OME)反复发作的主要影响因素,为防止分泌性中耳炎的复发提供临床依据及预防对策。方法计算机检索PubMed、Web of Science、Embase、The Cochrane Library、CNKI、VIP、WanFang Data和CBM等数据库查找关于分泌性中耳炎复发危险因素的相关文献,并追踪纳入文献的参考文献。采用R3.6.3软件进行Meta分析。结果共纳入17篇病例对照研究。Meta分析各危险因素的合并OR值及95%CI分别为:反复上呼吸道感染(OR=2.58,95%CI:1.35～4.93),慢性鼻窦炎(OR=2.33,95%CI:1.01～5.39),变应性鼻炎(OR=5.35,95%CI:2.31～12.40),腺样体肥大(OR=2.08,95%CI:0.90～4.80),扁桃体炎症(OR=0.91,95%CI:0.59～1.41),乳突气化不良(OR=6.15,95%CI:3.20～11.84),被动吸烟史(OR=1.96,95%CI:1.05～3.64),既往中耳炎病史(OR=1.25,95%CI:0.68～2.30),鼻腔结构异常(OR=0.94,95%CI:0.70～1.26),咽鼓管功能障碍(OR=2.88,95%CI:0.68～12.24),既往鼓膜置管史(OR=1.04,95%CI:0.70～1.54),通气管保留时间小于6月(OR=1.60,95%CI:0.99～2.60)。结论分泌性中耳炎的复发与多种因素有关,其中反复上呼吸道感染、慢性鼻窦炎、变应性鼻炎、乳突气化不良、被动吸烟史可增加分泌性中耳炎复发的风险,凡是伴有上述危险因素者应早期对其进行干预,及时积极处理或考虑进行鼓膜切开置管,而不仅仅依靠患者的听力、病程、鼓膜情况决定是否置管。更多还原

【Abstract】 Objective To explore the main influencing factors of recurrent secretory otitis media(OME), and to provide clinical basis and preventive measures for preventing the recurrence of OME. Method Pub Med, Web of Science, Embase, The Cochrane Library, CNKI, VIP, Wanfang Data and CBM databases were searched for associated studies. The risk factors for recurrent OME were retrieved from individual studies and the pooled estimates generated by R3.6.3 software. Result Seventeen case-control studies were included in the meta-analysis. The pooled odds ratio(OR) values and 95%CI of each risk factor were respectively repeated upper respiratory tract infections(OR=2.58,95%CI:1.35～4.93), chronic sinusitis(OR=2.33,95%CI:1.01～5.39), allergic rhinitis(OR=5.35,95%CI:2.31～12.40), adenoid vegetation(OR=2.08,95%CI:0.90～4.80), tonsillitis(OR=0.91,95%CI:0.59～1.41), poor pneumatization of mastoids(OR=6.15,95%CI:3.20～11.84), environmental tobacco smoking(OR=1.96,95%CI:1.05～3.64), tympanitis medical history(OR=1.25,95%CI:0.68～2.30), abnormal nasalcavity structures(OR=0.94,95%CI:0.70～1.26), eustachian tube disfunction(OR=2.88,95%CI:0.68～12.24), tympanotomy tube insertion medical history(OR=1.04,95%CI:0.70～1.54), Less than 6 months of tympanotomy tube insertion time(OR=1.60,95%CI:0.99～2.60). Conclusion Recurrence of OME is associated with a variety of factors, including repeated upper respiratory tract infections, chronic sinusitis, allergic rhinitis, poor pneumatization of mastoids, environmental tobacco smoking. These factors may increase the risk of OME, so patients who with these risk factors should be treated early, timely and positive treatment or tympanostomy tube should be taken into consideration. Do not just rely on the patient’s hearing, course of disease, tympanic membrane condition to decide whether to insert ventilation tube or not.更多还原