儿童中耳中炎与输液 (OME) 的自膨胀
Katie E Webster1, Caroline A Mulvaney1, Kevin Galbraith1
1Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
The Cochrane database of systematic reviews
|September 26, 2023
概括
自动膨胀可以改善生活质量,并减少中耳液的中耳炎与输液 (OME) 的儿童. 然而,关于听力改善和疼痛的证据是不确定的,必须权衡好处与潜在的耳痛.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 基于证据的医学基于证据的医学.
- 临床试验 临床试验
背景情况:
- 带出血的中耳炎 (OME) 在幼儿中很常见,可能导致听力损失和发育迟缓.
- 管理选项包括警等待,医疗,手术和机械治疗.
- 自动膨胀是一种自给自取的技术,使用正鼻压来通风中耳,帮助清除液体.
研究的目的:
- 评估自发炎治疗中耳炎的疗效,包括益处和危害,用于治疗儿童的中耳炎.
- 综合随机对照试验和准随机试验的证据.
主要方法:
- 在多个数据库 (Cochrane ENT Register,CENTRAL,MEDLINE,Embase,Web of Science,ClinicalTrials.gov,ICTRP) 进行全面的文献搜索,截至2023年1月20日.
- 包括6个月至12岁儿童的OME随机和准随机试验.
- 主要结局:听力,OME特异性生活质量,疼痛/焦虑. 二次结果包括OME持久性,不良影响和发展里程碑. 用于确定性评估的GRADE方法.
主要成果:
- 包括11项研究 (1036名参与者),主要比较自发性膨胀与不接受治疗.
- 自动通胀对恢复正常听力的影响的证据非常不确定 (确定性非常低).
- 自动通胀可能适度改善OME特定的生活质量 (低确定性),并在三个月后略有减少OME持久性 (低确定性).
- 关于耳朵疼痛风险增加的证据非常不确定 (确定性非常低).
结论:
- 在OME治疗中,对自身通胀的证据的整体确定性低至非常低.
- 自动通胀可能为OME特定的生活质量和持续性提供短期好处,但对听力和不良事件的影响仍然不确定.
- 潜在的益处需要仔细考虑手术的不便和可能导致耳朵疼痛的风险.
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