中华耳科学杂志

目的了解中国山东滨州地区儿童分泌性中耳炎的发病率及各种致病因素。方法在山东省滨州市按照随机整群抽样的流行病学调查方法,共随机抽取小学、幼儿园2～7岁儿童1536例,分2～3岁、4～5岁、6～7岁三个年龄组,以鼓室导抗为诊断标准,结合耳镜检查,对儿童分泌性中耳炎进行横断面流行病学调查。结果山东省滨州市2～7岁儿童分泌性中耳炎发病率为6.25%。2～3岁发病率为19.65%,4～5岁发病率为5.85%,6～7岁发病率为2.68%。2～3岁发病率最高,随着年龄的增长发病率有所降低,年龄组发病率差异有统计学意义。中国山东省滨州市2～3岁、4～5岁、6～7岁儿童分泌性中耳炎的发病率与西方文献报道差异无显著性。儿童分泌性中耳炎病因复杂,包括鼻-鼻窦炎、变应性鼻炎、扁桃体炎及腺样体肥大等,鼻、咽部疾病所占比例大,尤其是腺样体肥大所占比例最大。结论儿童分泌性中耳炎的发病率较高,病因复杂。

Objective An epidemiological investigation of secretory otitis media(SOM) in children was performed at Bingzhou City,Shandong Province to address its prevalence and various risk factors.Methods A two-stage random cluster sampling procedure is used to survey 1,536 two to seven-year-old children in 7 primary schools and kindergartens at Bingzhou City,divided into 2 to 3,4 to 5 and 6 to 7-year-old groups.The tympanogram was obtained and the ear was examined to make a diagnosis of secretory otitis media among these children.Results In the survey of 1,536 two to seven-year-old children,SOM was detected in 96 cases;the total prevalence of SOM was 6.25 percent.The prevalence of the three age groups was as follows:2 to 3-year-old,19.65 percent,4 to 5-year-old,5.85 percent and 6 to 7-year-old,2.68 percent,with a statistically significant difference.The highest incidence occurred at 2 to 3 years of age and decreased with increasing age.The prevalence rates of SOM in Chinese children of age 2-3,4-5 and 6-7 in Bingzhou City are not significantly different from those reported in the literature of the West.The risk factors of secretory otitis media in children were diverse,including adenoid hypertrophy,tonsillitis,sinusitis and allergic rhinitis.Diseases of the nose and nasopharynx were leading risk factors,especially adenoid hypertrophy.Conclusion The prevalence of secretory otitis media in children is high and its causes are diverse and diseases of the nose and nasopharynx are leading risk factors.