这个孩子有急性中耳炎吗?
Russell Rothman1, Thomas Owens, David L Simel
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn 37232, USA. russell.rothman@vanderbilt.edu
JAMA
|September 25, 2003
概括
儿童急性中耳炎 (AOM) 的准确诊断依赖于特定的体检结果. 在气动耳视镜检查中,阴暗的,凸起的或不动的鼓膜是AOM的关键指标.
科学领域:
- 儿科医学 儿科医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 诊断准确性研究 诊断准确性研究
背景情况:
- 急性中耳炎 (AOM) 是一个常见的儿科疾病.
- 准确的AOM诊断对于适当的管理和随访至关重要.
研究的目的:
- 系统地审查有关患者病史和儿童AOM体检诊断准确性的文献.
- 在诊断AOM时确定各种症状和迹象的精度和准确性.
主要方法:
- 搜索了MEDLINE和英语语言研究 (1966-2002) 关于AOM诊断准确性的文献.
- 包括研究与历史或儿童AOM体检的原始数据.
- 对症状和征兆的计算概率 (LRs),在必要时调整偏差.
主要成果:
- 耳朵疼痛是最有用的症状 (积极的LR,3.0-7.3).
- 阴 (调整的LR,34),凸起 (调整的LR,51),或不移动 (调整的LR,31) tympanic 膜是AOM的高度指示.
- 明显红色的耳膜有助于 (调整LR,8.4),而正常的颜色表明没有AOM (调整LR,0.2).
结论:
- 尽管研究的局限性,具体的物理发现是最有价值的AOM诊断.
- 阴,凸起或不移动的耳膜是最强烈的指标.
- tympanic 膜的红斑也是一个有用的标志,正常的颜色使 AOM 不太可能.
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