儿童期急性中耳炎诊断:2023年仍然是一个问题吗?
Francesco Folino1, Marco Caruso1, Pietro Bosi1
1Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Via F. Sforza 35, 20122, Milano, Italy.
Italian journal of pediatrics
|January 25, 2024
概括
在儿童中诊断急性中耳炎 (AOM) 是具有挑战性的. 一项研究发现,初级保健医生在27.6%的病例中误诊了AOM,经常将耳朵红色误认为没有凸起的鼓膜的感染.
科学领域:
- 儿科 儿科 儿科
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 传染性疾病 传染性疾病
背景情况:
- 在儿童中诊断急性中耳炎 (AOM) 存在挑战,因为非特异性症状和难以可视化 tympanic 膜.
- 准确的AOM诊断对于适当的治疗和预防并发症至关重要.
研究的目的:
- 评估初级保健儿科医生和专业耳视镜医生在AOM检测中的诊断协议.
- 在AOM识别中识别常见的诊断错误.
主要方法:
- 复发性AOM (RAOM) 的儿童的临床图表的回顾性分析.
- 经验丰富的医生根据耳视镜发现 (高血压或黄色的凸起耳鼓) 验证AOM诊断.
- 在初级保健/ER儿科医生和验证员之间计算诊断一致率.
主要成果:
- 分析包括87名儿童的134次AOM发作.
- 初级保健/急救儿科医生和验证人员之间的诊断一致率为72.4%.
- 主要的诊断陷是错误地识别小膜高血症没有膨胀为AOM (32/37个未经验证的诊断).
结论:
- 对儿科医生来说,诊断急性中耳炎仍然是一个重大挑战.
- 没有膨胀的耳膜高血是导致诊断混乱和潜在误诊的常见因素.
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