在儿童中,用于中耳炎与输液 (OME) 的腺切除术
Samuel MacKeith1, Caroline A Mulvaney2, Kevin Galbraith2
1ENT Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
The Cochrane database of systematic reviews
|October 23, 2023
概括
腺切除术可能会略微减少儿童持续性中耳炎与输液 (OME),但关于听力改善的证据尚不确定. 出血的风险很小,但需要更多的研究来确定哪些儿童从这种干预中获益最多.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 儿科手术 儿科手术
- 基于证据的医学基于证据的医学.
背景情况:
- 中耳炎与溢出 (OME) 是一种常见的儿童疾病,导致中耳液,可能导致听力损失和发育问题.
- 对OME的管理选择包括警等待,自膨胀和外科干预,如腺切除术,通常使用通风管.
研究的目的:
- 评价腺切除术的益处和危害,有或没有通风管,用于治疗儿童的OME.
- 综合来自随机和准随机受控试验的证据,将腺切除术与非手术或没有治疗进行比较.
主要方法:
- 随机对照试验和准随机试验的系统审查和元分析.
- 包括6个月至12岁的儿童,患有单边或双边OME.
- 主要结局包括听力,中耳炎特定的生活质量和出血;次要结局包括OME持久性,不良影响和发展里程碑.
主要成果:
- 对腺切除术对听力恢复的影响的证据在比较中非常不确定.
- 腺切除术可能会略微减少OME的持续性,但临床意义很小,证据的确定性非常低.
- 手术后出血的风险似乎很小,尽管对一些比较的证据有限且不确定.
结论:
- 关于儿童OME腺切除术的总体证据确定性低至非常低.
- 虽然腺切除术可能会降低OME的持续性,但它对听力的影响需要进一步调查.
- 未来的研究应该专注于确定特定的患者亚组,这些患者最有可能从腺切除术中受益.
相关概念视频
01:23Chronic Pharyngitis
2.5K
Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
2.5K
01:26Tonsillitis II: Management
120
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
120
01:29Suctioning the Nasopharyngeal Airway
463
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
463
01:25Suctioning the Oropharyngeal Airway
232
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
232
01:26Endoscopic Studies II: Thoracocentesis
296
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
296
01:30Tonsillitis I: Introduction
281
Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
Etiology
Three primary contributing factors have been identified.
281