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[[File:Ear-anatomy-notext-small.png|thumb|240 px|right|中耳炎]]
'''中耳炎'''是[[中耳]]鼓室粘膜的[[炎症]]。多由[[細菌]][[感染]]引起。[[中医]]称此病为“耳脓”、“耳疳”，认为是因肝胆湿热（火）邪气盛行引起。
'''中耳炎'''是[[中耳]]鼓室粘膜的[[炎症]]。多由[[細菌]][[感染]]引起。[[中医]]称此病为“耳脓”、“耳疳”，认为是因肝胆湿热（火）邪气盛行引起。

{{Infobox disease
| Name = Otitis media
| Image =
| Caption = A bulging [[tympanic membrane]] with cloudy fluid behind it as is typical in a case of acute otitis media
| DiseasesDB = 29620
| DiseasesDB_mult= serous,<br/>{{DiseasesDB2|9406}} suppurative
| ICD10 = {{ICD10|H|65||h|65}}-{{ICD10|H|67||h|65}}
| ICD9 = {{ICD9|017.40}}, {{ICD9|055.2}}, {{ICD9|381.0}}, {{ICD9|381.1}}, {{ICD9|381.2}}, {{ICD9|381.3}}, {{ICD9|381.4}}, {{ICD9|382}}
| ICDO =
| OMIM =
| MedlinePlus = 000638
| MedlinePlus_mult= acute, {{MedlinePlus2|007010}} with effusion, {{MedlinePlus2|000619}} chronic
| eMedicineSubj = emerg
| eMedicineTopic = 351
| eMedicine_mult = <br/>{{eMedicine2|ent|426}} complications, {{eMedicine2|ent|209}} with effusion, {{eMedicine2|ent|212}} Medical treat., {{eMedicine2|ent|211}} Surgical treat. {{eMedicine2|ped|1689}}
| MeshID = D010033
}}
<!-- Definition and symptoms -->
'''Otitis media''' is a group of inflammatory diseases of the [[middle ear]].<ref name=Qu2014/> The two main types are '''acute otitis media''' ('''AOM''') and '''otitis media with effusion''' ('''OME''').<ref name=CDC2013Ear/> AOM is an [[infection]] of abrupt onset that usually presents with ear pain.<!-- <ref name=Peads2013/> --> In young children this may result in pulling at the ear, increased crying, and poor sleep.<!-- <ref name=Peads2013/> --> Decreased eating and a [[fever]] may also be present.<!-- <ref name=Peads2013/> --> OME is typically not associated with symptoms.<ref name=Peads2013/> Occasionally a feeling of fullness is described.<!-- <ref name=Min2014/> --> It is defined as the presence of non-infectious fluid in the middle ear for more than three months.<!-- <ref name=Min2014/> --> '''Chronic suppurative otitis media''' ('''CSOM''') is middle ear inflammation of greater than two weeks that results in episodes of discharge from the ear.<!-- <ref name=Min2014/> --> It may be a complication of acute otitis media.<!-- <ref name=Min2014/> --> Pain is rarely present.<ref name=Min2014/> All three may be associated with [[hearing loss]].<ref name=Qu2014>{{cite journal|last1=Qureishi|first1=A|last2=Lee|first2=Y|last3=Belfield|first3=K|last4=Birchall|first4=JP|last5=Daniel|first5=M|title=Update on otitis media - prevention and treatment.|journal=Infection and drug resistance|date=10 January 2014|volume=7|pages=15-24|pmid=24453496|doi=10.2147/IDR.S39637}}</ref><ref name=CDC2013Ear/> The hearing loss in OME, due to its chronic nature, may affect a child's ability to learn.<ref name=Min2014/>
<!-- 定義與症狀 -->

中耳炎是一系列中耳發炎疾病之統稱[1]。.其中以[[急性中耳炎]]和[[中耳積水]]兩型最為常見[2]。急性中耳炎為急性感染所致，耳朵疼痛為其常見的臨床症狀。罹患急性中耳炎的幼童，常有拉扯耳朵、哭聲次數增加及睡眠品質不佳等情況。
<!-- Cause and diagnosis -->
The cause of AOM is related to childhood [[anatomy]] and [[immune system|immune function]].<!-- <ref name=Min2014/> --> Either bacteria or viruses may be involved.<!-- <ref name=Min2014/> --> Risk factors include: exposure to smoke, use of [[pacifiers]], and attending daycare.<!-- <ref name=Min2014/> --> It occurs more commonly in those who are [[Native American]] or who have [[Down syndrome]].<ref name=Min2014>{{cite journal|last1=Minovi|first1=A|last2=Dazert|first2=S|title=Diseases of the middle ear in childhood.|journal=GMS current topics in otorhinolaryngology, head and neck surgery|date=2014|volume=13|pages=Doc11|pmid=25587371|doi=10.3205/cto000114}}</ref> OME frequently occurs following AOM but may also be related to [[viral upper respiratory infection]]s, irritants such as smoke, or [[allergies]].<ref name=Min2014/><ref name=CDC2013Ear>{{cite web|title=Ear Infections|url=http://www.cdc.gov/getsmart/antibiotic-use/URI/ear-infection.html|website=cdc.gov|accessdate=14 February 2015|date=September 30, 2013}}</ref> Looking at the eardrum is important for making the correct diagnosis.<ref name=Coker2010>{{cite journal|last1=Coker|first1=TR|last2=Chan|first2=LS|last3=Newberry|first3=SJ|last4=Limbos|first4=MA|last5=Suttorp|first5=MJ|last6=Shekelle|first6=PG|last7=Takata|first7=GS|title=Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review.|journal=JAMA|date=17 November 2010|volume=304|issue=19|pages=2161–9|pmid=21081729|doi=10.1001/jama.2010.1651}}</ref> Signs of AOM include bulging or a lack of movement of the [[tympanic membrane]] from a puff of air.<ref name=CDC2013A/><ref name=Peads2013>{{cite journal|last1=Lieberthal|first1=AS|last2=Carroll|first2=AE|last3=Chonmaitree|first3=T|last4=Ganiats|first4=TG|last5=Hoberman|first5=A|last6=Jackson|first6=MA|last7=Joffe|first7=MD|last8=Miller|first8=DT|last9=Rosenfeld|first9=RM|last10=Sevilla|first10=XD|last11=Schwartz|first11=RH|last12=Thomas|first12=PA|last13=Tunkel|first13=DE|title=The diagnosis and management of acute otitis media.|journal=Pediatrics|date=March 2013|volume=131|issue=3|pages=e964-99|pmid=23439909|doi=10.1542/peds.2012-3488}}</ref> New discharge not related to [[otitis externa]] also indicates the diagnosis.<ref name=Peads2013/>
<!-- 病因與診斷 -->

造 成急性中耳炎的原因與孩童時代的解剖構造或免疫系統功能有關。細菌或病毒都有可能是致病因子。危險因子包含：暴露於煙霧中、使用奶嘴，以及待在日間托兒中 心。急性中耳炎較常發生在美洲原住民或唐氏症患者身上[4]。中耳積水則常常伴隨在急性中耳炎之後發生，但也可能與上呼吸道病毒感染、煙霧或過敏原等刺激 物有關 [4][2]。耳膜視診對於做出正確的診斷來說是重要的[5]。急性中耳炎的病徵包括耳膜向外凸出、無法像在正常情況下那樣受空氣的擾動而震動[6] [3]，或是有新分泌物出現且分泌物並非源自外耳炎[3]。

<!-- Prevention and treatment -->
A number of measures decrease the risk of otitis media including: [[pneumococcal vaccine|pneumococcal]] and [[influenza vaccine|influenza vaccination]], exclusive [[breastfeeding]] for the first six months of life, and avoiding tobacco smoke.<ref name=Peads2013/> In those with otitis media with effusion [[antibiotic]]s do not generally speed recovery.<ref name=CDC2013A>{{cite web|title=Otitis Media: Physician Information Sheet (Pediatrics)|url=http://www.cdc.gov/getsmart/campaign-materials/info-sheets/child-otitismedia.html|website=cdc.gov|accessdate=14 February 2015|date=November 4, 2013}}</ref><ref>{{cite journal|last1=van Zon|first1=A|last2=van der Heijden|first2=GJ|last3=van Dongen|first3=TM|last4=Burton|first4=MJ|last5=Schilder|first5=AG|title=Antibiotics for otitis media with effusion in children.|journal=The Cochrane database of systematic reviews|date=12 September 2012|volume=9|pages=CD009163|pmid=22972136|doi=10.1002/14651858.CD009163.pub2}}</ref> The use of [[analgesic|pain medications]] for AOM is important.<ref name=Peads2013/> This may include: [[paracetamol]] (acetaminophen), [[ibuprofen]], [[benzocaine]] ear drops, or [[opioids]].<ref name=Peads2013/> In AOM antibiotics may speed recovery but may result in side effects.<ref>{{cite journal|last1=Venekamp|first1=RP|last2=Sanders|first2=S|last3=Glasziou|first3=PP|last4=Del Mar|first4=CB|last5=Rovers|first5=MM|title=Antibiotics for acute otitis media in children.|journal=The Cochrane database of systematic reviews|date=31 January 2013|volume=1|pages=CD000219|pmid=23440776|doi=10.1002/14651858.CD000219.pub3}}</ref> Antibiotics are often recommended in those with severe disease or under two years old.<!-- <ref name=CDC2013A/> --> In those with less severe disease they may only be recommended in those who do not improve after two or three days.<ref name=CDC2013A/> The initial antibiotic of choice is typically [[amoxicillin]].<!-- <ref name=Peads2013/> --> In those with frequent infections [[tympanostomy tubes]] may decrease recurrence.<ref name=Peads2013/>
<!-- 預防與治療 -->

注射肺炎鏈球菌疫苗、流感疫苗、六個月以下的嬰兒完全餵母乳以及避免接觸香煙能夠降低罹患中耳炎的風險。[3]在滲出性中耳炎的病患使用抗生素不會加速疾病的復原。[6][7]在急性中耳炎的病患使用止痛劑是很重要的，這包括了对乙酰氨基酚 (acetaminophen) , 布洛芬(ibuprofen), 苯佐卡因(benzocaine)耳藥水以及鴉片類止痛劑。[3]抗生素能夠加速急性中耳炎的恢復，但有可能會造成副作用。抗生素被建議使用在病情嚴重或小於兩歲的病患。對於病情較不嚴重的病患，抗生素只有被建議在兩或三天後病情還沒有改善的病患上使用。[6]一般上會先使用安莫西林(amoxicilin)來當做抗生素。對於反复中耳炎感染的病患，鼓膜造孔術可能可以降低復發率。[3]
<!-- Epidemiology -->
Worldwide AOM affect about 11% of people a year (about 710&nbsp; million cases).<ref name=Mon2012/> Half the cases involve children less than five years of age and it is more common among males.<ref name=Min2014/><ref name=Mon2012/> Of those affected about 4.8% or 31&nbsp;million develop chronic suppurative otitis media.<ref name=Mon2012>{{cite journal|last1=Monasta|first1=L|last2=Ronfani|first2=L|last3=Marchetti|first3=F|last4=Montico|first4=M|last5=Vecchi Brumatti|first5=L|last6=Bavcar|first6=A|last7=Grasso|first7=D|last8=Barbiero|first8=C|last9=Tamburlini|first9=G|title=Burden of disease caused by otitis media: systematic review and global estimates.|journal=PLOS ONE|date=2012|volume=7|issue=4|pages=e36226|pmid=22558393|doi=10.1371/journal.pone.0036226|pmc=3340347}}</ref> Before the age of ten OME affects about 80% of children at some point in time.<ref name=Min2014/> Otitis media resulted in 2,400 deaths in 2013 – down from 4,900 deaths in 1990.<ref name=GBD204>{{cite journal|last1=GBD 2013 Mortality and Causes of Death|first1=Collaborators|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=17 December 2014|pmid=25530442|doi=10.1016/S0140-6736(14)61682-2|volume=385|issue=9963|pages=117–71}}</ref>

⚫
[[File:Ear-anatomy-notext-small.png|thumb|240 px|right|中耳炎]]


== 中耳炎種類 ==
== 中耳炎種類 ==

2015年12月16日 (三) 05:11的版本

维基百科中的醫學内容仅供参考，並不能視作專業意見。如需獲取醫療幫助或意見，请咨询专业人士。詳見醫學聲明。

中耳炎是中耳鼓室粘膜的炎症。多由細菌感染引起。中医称此病为“耳脓”、“耳疳”，认为是因肝胆湿热（火）邪气盛行引起。

Otitis media
类型中耳疾病[*]、炎症性疾病[*]、疾病
分类和外部资源
醫學專科耳鼻喉科學
ICD-10H65-H67
ICD-9-CM017.40, 055.2, 381.0, 381.1, 381.2, 381.3, 381.4, 382
DiseasesDB29620 serous,
9406 suppurative
MedlinePlus000638 acute, 007010 with effusion, 000619 chronic
eMedicineemerg/351
ent/426 complications, ent/209 with effusion, ent/212 Medical treat., ent/211 Surgical treat. ped/1689
MeSHD010033
[编辑此条目的维基数据]

Otitis media is a group of inflammatory diseases of the middle ear.[1] The two main types are acute otitis media (AOM) and otitis media with effusion (OME).[2] AOM is an infection of abrupt onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present. OME is typically not associated with symptoms.[3] Occasionally a feeling of fullness is described. It is defined as the presence of non-infectious fluid in the middle ear for more than three months. Chronic suppurative otitis media (CSOM) is middle ear inflammation of greater than two weeks that results in episodes of discharge from the ear. It may be a complication of acute otitis media. Pain is rarely present.[4] All three may be associated with hearing loss.[1][2] The hearing loss in OME, due to its chronic nature, may affect a child's ability to learn.[4]

中耳炎是一系列中耳發炎疾病之統稱[1]。.其中以急性中耳炎和中耳積水兩型最為常見[2]。急性中耳炎為急性感染所致，耳朵疼痛為其常見的臨床症狀。罹患急性中耳炎的幼童，常有拉扯耳朵、哭聲次數增加及睡眠品質不佳等情況。 The cause of AOM is related to childhood anatomy and immune function. Either bacteria or viruses may be involved. Risk factors include: exposure to smoke, use of pacifiers, and attending daycare. It occurs more commonly in those who are Native American or who have Down syndrome.[4] OME frequently occurs following AOM but may also be related to viral upper respiratory infections, irritants such as smoke, or allergies.[4][2] Looking at the eardrum is important for making the correct diagnosis.[5] Signs of AOM include bulging or a lack of movement of the tympanic membrane from a puff of air.[6][3] New discharge not related to otitis externa also indicates the diagnosis.[3]

造 成急性中耳炎的原因與孩童時代的解剖構造或免疫系統功能有關。細菌或病毒都有可能是致病因子。危險因子包含：暴露於煙霧中、使用奶嘴，以及待在日間托兒中 心。急性中耳炎較常發生在美洲原住民或唐氏症患者身上[4]。中耳積水則常常伴隨在急性中耳炎之後發生，但也可能與上呼吸道病毒感染、煙霧或過敏原等刺激 物有關 [4][2]。耳膜視診對於做出正確的診斷來說是重要的[5]。急性中耳炎的病徵包括耳膜向外凸出、無法像在正常情況下那樣受空氣的擾動而震動[6] [3]，或是有新分泌物出現且分泌物並非源自外耳炎[3]。

A number of measures decrease the risk of otitis media including: pneumococcal and influenza vaccination, exclusive breastfeeding for the first six months of life, and avoiding tobacco smoke.[3] In those with otitis media with effusion antibiotics do not generally speed recovery.[6][7] The use of pain medications for AOM is important.[3] This may include: paracetamol (acetaminophen), ibuprofen, benzocaine ear drops, or opioids.[3] In AOM antibiotics may speed recovery but may result in side effects.[8] Antibiotics are often recommended in those with severe disease or under two years old. In those with less severe disease they may only be recommended in those who do not improve after two or three days.[6] The initial antibiotic of choice is typically amoxicillin. In those with frequent infections tympanostomy tubes may decrease recurrence.[3]

注射肺炎鏈球菌疫苗、流感疫苗、六個月以下的嬰兒完全餵母乳以及避免接觸香煙能夠降低罹患中耳炎的風險。[3]在滲出性中耳炎的病患使用抗生素不會加速疾病的復原。[6][7]在急性中耳炎的病患使用止痛劑是很重要的，這包括了对乙酰氨基酚 (acetaminophen) , 布洛芬(ibuprofen), 苯佐卡因(benzocaine)耳藥水以及鴉片類止痛劑。[3]抗生素能夠加速急性中耳炎的恢復，但有可能會造成副作用。抗生素被建議使用在病情嚴重或小於兩歲的病患。對於病情較不嚴重的病患，抗生素只有被建議在兩或三天後病情還沒有改善的病患上使用。[6]一般上會先使用安莫西林(amoxicilin)來當做抗生素。對於反复中耳炎感染的病患，鼓膜造孔術可能可以降低復發率。[3] Worldwide AOM affect about 11% of people a year (about 710  million cases).[9] Half the cases involve children less than five years of age and it is more common among males.[4][9] Of those affected about 4.8% or 31 million develop chronic suppurative otitis media.[9] Before the age of ten OME affects about 80% of children at some point in time.[4] Otitis media resulted in 2,400 deaths in 2013 – down from 4,900 deaths in 1990.[10]

中耳炎

中耳炎種類

  • 急性中耳炎
    • 急性中耳炎一般是在3週內發生感染，常常是感冒的并发症，常見的是細菌（肺炎雙球菌、流行性感冒嗜血桿菌、葡萄球菌）由口鼻喉，經過耳咽管進入中耳，或是過敏性鼻炎病人的過敏性反應，另外乘飞机时的耳部不适也属于急性中耳炎，其主要症状是听力减退、耳鸣、耳内疼痛。在哈欠、打喷嚏或换鼻涕时，因咽鼓管（即连接中耳鼓室与鼻咽部的一条细狭管道）暂时开放，症状有片刻好转。而耳痛及听力下降可首先被病人感受到。
  • 滲出性中耳炎
  • 慢性中耳炎中耳炎持續三個月以上。
  • 真珠腫性中耳炎

診療科

參見

规范控制数据库：各地 編輯維基數據鏈接
外耳
中耳和乳突
内耳和径路
共同径路
过量反应
其他
耳朵索引
描述
疾病
治療
  1. ^ 1.0 1.1 Qureishi, A; Lee, Y; Belfield, K; Birchall, JP; Daniel, M. Update on otitis media - prevention and treatment.. Infection and drug resistance. 10 January 2014, 7: 15–24. PMID 24453496. doi:10.2147/IDR.S39637. 
  2. ^ 2.0 2.1 2.2 Ear Infections. cdc.gov. September 30, 2013 [14 February 2015]. 
  3. ^ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Lieberthal, AS; Carroll, AE; Chonmaitree, T; Ganiats, TG; Hoberman, A; Jackson, MA; Joffe, MD; Miller, DT; Rosenfeld, RM; Sevilla, XD; Schwartz, RH; Thomas, PA; Tunkel, DE. The diagnosis and management of acute otitis media.. Pediatrics. March 2013, 131 (3): e964–99. PMID 23439909. doi:10.1542/peds.2012-3488. 
  4. ^ 4.0 4.1 4.2 4.3 4.4 4.5 Minovi, A; Dazert, S. Diseases of the middle ear in childhood.. GMS current topics in otorhinolaryngology, head and neck surgery. 2014, 13: Doc11. PMID 25587371. doi:10.3205/cto000114. 
  5. ^ Coker, TR; Chan, LS; Newberry, SJ; Limbos, MA; Suttorp, MJ; Shekelle, PG; Takata, GS. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review.. JAMA. 17 November 2010, 304 (19): 2161–9. PMID 21081729. doi:10.1001/jama.2010.1651. 
  6. ^ 6.0 6.1 6.2 Otitis Media: Physician Information Sheet (Pediatrics). cdc.gov. November 4, 2013 [14 February 2015]. 
  7. ^ van Zon, A; van der Heijden, GJ; van Dongen, TM; Burton, MJ; Schilder, AG. Antibiotics for otitis media with effusion in children.. The Cochrane database of systematic reviews. 12 September 2012, 9: CD009163. PMID 22972136. doi:10.1002/14651858.CD009163.pub2. 
  8. ^ Venekamp, RP; Sanders, S; Glasziou, PP; Del Mar, CB; Rovers, MM. Antibiotics for acute otitis media in children.. The Cochrane database of systematic reviews. 31 January 2013, 1: CD000219. PMID 23440776. doi:10.1002/14651858.CD000219.pub3. 
  9. ^ 9.0 9.1 9.2 Monasta, L; Ronfani, L; Marchetti, F; Montico, M; Vecchi Brumatti, L; Bavcar, A; Grasso, D; Barbiero, C; Tamburlini, G. Burden of disease caused by otitis media: systematic review and global estimates.. PLOS ONE. 2012, 7 (4): e36226. PMC 3340347 可免费查阅. PMID 22558393. doi:10.1371/journal.pone.0036226. 
  10. ^ GBD 2013 Mortality and Causes of Death, Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.. Lancet. 17 December 2014, 385 (9963): 117–71. PMID 25530442. doi:10.1016/S0140-6736(14)61682-2. 
检索自“https://zh.wikipedia.org/w/index.php?title=中耳炎&oldid=38370051”