透气管 (管) 用于中耳炎与溢出 (OME) 在儿童中
Samuel MacKeith1, Caroline A Mulvaney2, Kevin Galbraith2
1ENT Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
The Cochrane database of systematic reviews
|November 15, 2023
概括
通风管 (grommets) 可能为儿童的听力和持续性中耳炎 (OME) 提供短期的小益处. 然而,关于长期影响和特定患者群体的证据非常不确定.
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) 是一种常见的儿童疾病,导致中耳液积聚.
- 持续的OME会导致听力损失,影响儿童的发育和生活质量.
- 插入通风管是OME的常见治疗方法.
研究的目的:
- 评估用于治疗儿童的OME的通风管 (管) 的益处和危害.
- 综合随机对照试验 (RCT) 的证据,将通风管与各种对照组进行比较.
主要方法:
- 对19项涉及2888名患有OME的6个月至12岁儿童的RCT进行了系统审查和元分析.
- 主要结局包括听力,OME特异性生活质量和持续的耳膜穿孔.
- 用GRADE方法来评估证据的确定性.
主要成果:
- 对通风管的证据与没有治疗的证据显示,对听力有非常不确定的益处,并在六个月后可能减少OME.
- 与警等待相比,听力或长期持久的OME几乎没有差异,证据确定性非常低.
- 关于通风管与神经切除术的证据表明,对OME有潜在的短期益处,但对听力有不确定的影响,对类似的穿孔风险有中等的确定性.
结论:
- 通风管可能会在听力和OME持久性方面提供小的,短期到中期的改善,但长期影响仍然不清楚.
- 对于大多数结果,证据的确定性低至非常低,限制了最终的结论.
- 需要进一步的研究来了解OME表型,并有效地针对干预措施,因为RCT可能不适合个体患者的决定.
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