厦门大学附属成功医院暨陆军第73集团军医院 厦门 361003
童梓德 本科 副主任医师; 研究方向:耳鼻喉常见疾病,E-mail: tongzide0606@163.com
收稿:2025-03-18,
纸质出版:2025-11-15
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童梓德,赖世佳,吴华.288例分泌性中耳炎患儿听力损失情况及影响因素分析[J].中国听力语言康复科学杂志,2025,23(06):581-585.
TONG Zi-de,LAI Shi-jia,WU Hua.Analysis of Hearing Loss and Influencing Factors in 288 Children with Otitis Media with Effusion[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2025,23(06):581-585.
童梓德,赖世佳,吴华.288例分泌性中耳炎患儿听力损失情况及影响因素分析[J].中国听力语言康复科学杂志,2025,23(06):581-585. DOI: 10.3969/j.issn.1672-4933.2025.06.006.
TONG Zi-de,LAI Shi-jia,WU Hua.Analysis of Hearing Loss and Influencing Factors in 288 Children with Otitis Media with Effusion[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2025,23(06):581-585. DOI: 10.3969/j.issn.1672-4933.2025.06.006.
目的
2
分析288例分泌性中耳炎(otitis media with effusion, OME)患儿听力损失情况及影响因素。
方法
2
本研究为回顾性研究,选取2020年1月~2024年12月在本院治疗的288例OME患儿作为研究对象,根据是否合并听力损失划分为听力损失组和无听力损失组。收集并对比两组患儿临床资料及病情特征,通过单因素及多因素logistic回归分析OME患儿合并听力损失的影响因素。通过受试者工作特征曲线评价各影响因素预测OME患儿合并听力损失的效能。
结果
2
入组的288例OME患儿中男性160例、女性128例,平均年龄7.61±1.58岁,病程3.09±1.31月,其中合并听力损失102例,发生率为35.4%。听力损失组患儿病程、合并呼吸道感染病史、过敏性鼻炎病史、腺样体肥大病史、耳部疾病家族史占比均显著高于无听力损失组(
P
<
0.05);听力损失组患儿中鼓膜穿孔、胶耳、腺样体肥大3~4度、中重度咽鼓管阻塞、咽鼓管开放功能异常占比显著高于无听力损失组 (
P
<
0.05);听力损失组患儿中父母吸烟占比显著高于无听力损失组(
P
<
0.05);单因素及多因素logistic回归分析结果显示,病程[OR(95%CI)=1.274 (1.034~1.569)]、中耳积液性质为胶耳[OR(95%CI)=2.260 (1.048~4.877)]、腺样体肥大3~4度[OR(95%CI)=2.017 (1.161~3.507)]、咽鼓管开放功能异常[OR(95%CI)=1.908 (1.095~3.324)]、父母吸烟[OR(95%CI)=1.843 (1.045~3.249)]为OME患儿合并听力损失的独立危险因素(
P
<
0.05);病程、中耳积液性质为胶耳、腺样体肥大3~4度、咽鼓管开放功能异常、父母吸烟5项联合预测OME患儿合并听力损失的AUC值为 0.726(95%
CI
:0.666~0.786,
P
<
0.001),预测敏感度、特异度分别为71.34%、72.45%。
结论
2
病程较长、中耳积液性质为胶耳、腺样体肥大3~4度、咽鼓管开放功能异常、父母吸烟的OME患儿更易合并听力损失,需根据针对患儿病情特征及环境因素进行早期干预,防止患儿听力损失的发生及加重。
Objective
2
To analyze the hearing loss and its influencing factors in 288 children with otitis media with effusion (OME).
Methods
2
This study was a retrospective study. 288 children with OME treated at our hospital from January 2020 to December 2024 were selected as the research subjects. They were divided into the hearing loss group and the non-hearing loss group according to whether they had combined hearing loss. The clinical data and disease characteristics of the two groups of children were collected and compared. Univariate and multivariate logistic regression analyses were conducted to explore the influencing factors for hearing loss in children with OME. The efficacy of each influencing factor in predicting hearing loss in children with OME was evaluated by the receiver operating characteristic curve (ROC).
Results
2
Among the 288 OME children enrolled in the study
there were 160 males and 128 females. The average age was (7.61±1.58) years old
and the disease duration was (3.09±1.31) months. Among them
102 cases had concurrent hearing loss
with an incidence rate of 35.4%. The duration of the disease
the proportions of children with a history of combined respiratory tract infections
combined allergic rhinitis
combined adenoid hypertrophy
and a family history of combined ear diseases in the hearing loss group were all higher than those in the non-hearing loss group (
P
<
0.05). The proportions of tympanic membrane perforation
glue ear
adenoid hypertrophy of grade 3 - 4
moderate to severe eustachian tube obstruction
and abnormal eustachian tube opening function in the hearing loss group were higher than those in the non-hearing loss group (
P
<
0.05). The proportion of children whose parents smoked in the hearing loss group was higher than that in the non-hearing loss group (
P
<
0.05). The results of univariate and multivariate logistic regression analyses showed that the duration of the disease [OR (95%CI) = 1.274 (1.034 - 1.569)
]
the nature of middle ear effusion being glue ear [OR (95%CI) = 2.260 (1.048 - 4.877)
]
adenoid hypertrophy of grade 3 - 4 [OR (95%CI) = 2.017 (1.161 - 3.507)
]
abnormal eustachian tube opening function [OR (95%CI) = 1.908 (1.095 - 3.324)
]
and paren
ts smoking [OR (95%CI) = 1.843 (1.045 - 3.249)
]
were independent risk factors for hearing loss in children with OME (all P values
<
0.05). The AUC values for predicting hearing loss in children with OME by the duration of the disease
the nature of middle ear effusion being glue ear
adenoid hypertrophy of grade 3 - 4
abnormal eustachian tube opening function
parents smoking alone and in combination of these five factors were 0.726 (95%CI: 0.666 - 0.786
P
<
0.001)
with a prediction sensitivity of 71.34% and a specificity of 72.45%.
Conclusion
2
Children with OME who have a longer disease duration
glue ear as the nature of middle ear effusion
adenoid hypertrophy of grade 3 - 4
abnormal eustachian tube opening function
and parents who smoke are more likely to have combined hearing loss. Early interventions should be carried out according to the disease characteristics and environmental factors of children to prevent the occurrence and aggravation of hearing loss in children.
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