腺樣體切除術治療兒童分泌性中耳炎的系統評價_《中國循證醫學雜志》

作者：

古慶家 ¹ , 劉亞峰 ¹ , 周光耀 ¹ , 秦學玲 ¹ , 梁傳余 ¹ , 衛茂玲 ² , 張鳴明 ²

1. 四川大學華西醫院耳鼻咽喉科,成都,6100412. 四川大學華西醫院中國循證醫學中心;

關鍵詞：

腺樣體切除術兒童分泌性中耳炎系統評價

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目的　評價腺樣體切除術(adenoidectomy,AT)治療兒童分泌性中耳炎(otitis media with effusion,OME)的療效及安全性.
方法　機檢Medline(1966～2001)、EMbase(1974～2001)、Cochrane 臨床對照試驗資料庫(CCTR)和中國生物醫學文獻數據庫(CBM,1989～2001),手檢5種國內耳鼻咽喉科雜志的有關文獻,查閱合格文章的參考文獻,篩選出符合納入標準的AT治療兒童OME的隨機對照試驗,至少由兩位研究者獨立評估試驗質量和提取數據.應用RevMan 4.1軟件進行統計學分析.
結果　共收集到相關文獻248篇,共納入文獻13篇,1 430例病人(耳).這13篇文獻總的方法學質量較高,全部來自歐、美國家.在AT與鼓膜切開術以及不治療比較的試驗中,未發現AT的療效優于其他療法.AT與鼓膜置管術比較的4個試驗提示,鼓膜置管術的療效優于AT.10篇文獻描述了術后出血、鼻咽狹窄和腭咽功能不全等并發癥.
結論　目前尚無證據表明AT治療OME的療效優于鼓膜切開術、鼓膜置管術和不治療,也沒有證據表明哪一種手術方式的療效最佳,但是必須注意其術后并發癥.對于藥物治療無效的OME患兒,如同時存在復發的多種危險因素,早期施行AT聯合鼓膜置管術可能為最合理的治療方法.

引用本文： 古慶家,劉亞峰,周光耀,秦學玲,梁傳余,衛茂玲,張鳴明. 腺樣體切除術治療兒童分泌性中耳炎的系統評價. 中國循證醫學雜志, 2004, 04(6): 389-392. doi: 復制

1.	［1］Gates GA, Avery CA, Prihoda TJ, Cooper JC. Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion[J ]. New Engl J Med, 1987;317(3) :1 444-1 451.
2.	［2］Bulman CH, Brook SJ, Berry MG. A prospective randomized trial of adenoidectomy vs grommet insertion in the treatment of glue ear [J]. Clin Otolaryngol, 1984; 9(1): 67-75.
3.	［3］Roydhouse N. Adenoidectomy for otitis media with effusion with mucoid effusion[J]. Ann Otol Rhinol Laryngol, 1980; 89(Suppl 68): 312-315.
4.	［4］Black N,CrowtherJ,Freeland A. The effectiveness of adenoidectomy in the treatment of glue ear: arandomized controlled trial[J]. Clin Otolaryngol, 1986; 11(2): 149-155.
5.	［5］Gates GA, Avery CA, Cooper JC. Chronic secretory otitis media: effects of surgical management [J]. Ann Otol Rhino Laryngol, 1989; Suppl138:2-32.
6.	［6］Terris MH, Magit AE, Davidson TM. Otitis media with effusion in infants and children[J]. Postgraduate medicine, 1995;97(1): 137-151.
7.	［7］Gates GA,Avery CA, Prihoda TJ. Effect of adenoidectomy upon children with chronic otitis media with effusion[J]. Laryngoscope, 1988; 98(1): 58-63.
8.	［8］Marshak G, Netian ZB. Adenooidectomy versus tympanostomy in chronic secretory otitis media[J]. Ann Otol Rhinol Laryngol, 1980; 89(Suppl 68,part2): 316-318.
9.	［9］Paradise JL, Blustone CD, Rogers KD, Taylor FH. Efficacy of adenoidectomy in recurrent otitis media-historical overriew and preliminary results from a ramdomized,controlled trial[J].Ann Otol Rhinol Laryndaryngol, 1980; 89 (Suppl 68,pait2): 319-321.
10.	［10］Black NA, Sanderson CF, Freeland AP, Vessey MP. A randomized controlled trial of surgery for glueear [ J ] . BMJ,1990; 300(6 739): 1 551-1 556.
11.	［11］Gates GA, Muntz HR, Gaylis B. Adenooidectomy and otitis media[J]. Ann Otol Rhino Laryngol, 1992; 101 ( 1 ): 24-32.
12.	［12］Paradise JL, Blustone CD, Rogers KD, Taylor FH, Colborn DK, Bachman RZ, Bernard BS, Schwarzbach RH. Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement [ J ]. JAMA,1990; 263 (15) : 2066-2073.
13.	［13］Paradise JL, Blustone CD, Colbom DK, Bernard BS, Smith CG, Pockette HE, Lasky MK. Adenoidectomy and adenotonsillectomy for recurrent acute otitis media-parallel randomized clinical trials in children not previously treated with tympanostomy tubes[J]. JAMA, 1999; 282(10): 945-953.

1. ［1］Gates GA, Avery CA, Prihoda TJ, Cooper JC. Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion[J ]. New Engl J Med, 1987;317(3) :1 444-1 451.
2. ［2］Bulman CH, Brook SJ, Berry MG. A prospective randomized trial of adenoidectomy vs grommet insertion in the treatment of glue ear [J]. Clin Otolaryngol, 1984; 9(1): 67-75.
3. ［3］Roydhouse N. Adenoidectomy for otitis media with effusion with mucoid effusion[J]. Ann Otol Rhinol Laryngol, 1980; 89(Suppl 68): 312-315.
4. ［4］Black N,CrowtherJ,Freeland A. The effectiveness of adenoidectomy in the treatment of glue ear: arandomized controlled trial[J]. Clin Otolaryngol, 1986; 11(2): 149-155.
5. ［5］Gates GA, Avery CA, Cooper JC. Chronic secretory otitis media: effects of surgical management [J]. Ann Otol Rhino Laryngol, 1989; Suppl138:2-32.
6. ［6］Terris MH, Magit AE, Davidson TM. Otitis media with effusion in infants and children[J]. Postgraduate medicine, 1995;97(1): 137-151.
7. ［7］Gates GA,Avery CA, Prihoda TJ. Effect of adenoidectomy upon children with chronic otitis media with effusion[J]. Laryngoscope, 1988; 98(1): 58-63.
8. ［8］Marshak G, Netian ZB. Adenooidectomy versus tympanostomy in chronic secretory otitis media[J]. Ann Otol Rhinol Laryngol, 1980; 89(Suppl 68,part2): 316-318.
9. ［9］Paradise JL, Blustone CD, Rogers KD, Taylor FH. Efficacy of adenoidectomy in recurrent otitis media-historical overriew and preliminary results from a ramdomized,controlled trial[J].Ann Otol Rhinol Laryndaryngol, 1980; 89 (Suppl 68,pait2): 319-321.
10. ［10］Black NA, Sanderson CF, Freeland AP, Vessey MP. A randomized controlled trial of surgery for glueear [ J ] . BMJ,1990; 300(6 739): 1 551-1 556.
11. ［11］Gates GA, Muntz HR, Gaylis B. Adenooidectomy and otitis media[J]. Ann Otol Rhino Laryngol, 1992; 101 ( 1 ): 24-32.
12. ［12］Paradise JL, Blustone CD, Rogers KD, Taylor FH, Colborn DK, Bachman RZ, Bernard BS, Schwarzbach RH. Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement [ J ]. JAMA,1990; 263 (15) : 2066-2073.
13. ［13］Paradise JL, Blustone CD, Colbom DK, Bernard BS, Smith CG, Pockette HE, Lasky MK. Adenoidectomy and adenotonsillectomy for recurrent acute otitis media-parallel randomized clinical trials in children not previously treated with tympanostomy tubes[J]. JAMA, 1999; 282(10): 945-953.

《中國循證醫學雜志》

腺樣體切除術治療兒童分泌性中耳炎的系統評價

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《中國循證醫學雜志》

腺樣體切除術治療兒童分泌性中耳炎的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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