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\"01.jpg\"

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中耳炎是累及中耳（包括咽鼓管、鼓室、鼓窦及乳突气房）全部或部分结构的炎性病变，好发于儿童。可分为非化脓性及化脓性两大类。非化脓性者包括分泌性中耳炎、气压损伤性中耳炎等，化脓性者有急性和慢性之分。特异性炎症太少见，如结核性中耳炎等。

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中耳炎病因

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1.急性中耳炎是中耳黏膜的急性化脓性炎症，由咽鼓管途径感染。感冒后咽部、鼻部的炎症向咽鼓管蔓延，咽鼓管咽口及管腔黏膜出现充血、肿胀，纤毛运动发生障碍，引起中耳炎。常见的致病菌主要是肺炎球菌、流感嗜血杆菌等。

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2.鼻涕中含有大量的病毒和细菌，如果两侧鼻孔都捏住用力擤，则压力迫使鼻涕向鼻后孔挤出，到达咽鼓管，引发中耳炎。

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3.游泳时应避免将水咽入口中，以免水通过鼻咽部而进入中耳引发中耳炎。外伤所致的鼓膜穿孔，禁止滴任何水样液体，以免影响创口的愈合。可用消毒棉球堵塞外耳道，以免感染诱发中耳炎。

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4.如果婴幼儿仰卧位吃奶，由于幼儿的咽鼓管比较平直，且管腔较短，内径较宽，奶汁可经咽鼓管呛入中耳引发中耳炎。

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5.吸烟包括吸二手烟，也会引起中耳炎。吸烟可引起全身性的动脉硬化，尤其是香烟中的尼古丁进入血液，使小血管痉挛，血液黏度增加，给内耳供应血液的微动脉发生硬化，造成内耳供血不足，严重影响听力。

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6.长时间用耳机听摇滚类的大分贝的音乐，如果时间较长的话，也容易引起慢性中耳炎。

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临床表现

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1.化脓性中耳炎

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（1）急性化脓性中耳炎 由化脓性细菌感染引起的中耳炎症，其症状主要是耳痛、流脓。小儿的全身症状比成人明显，可有发热、呕吐等。严重的并发症有颅内并发症，如脑膜炎、脑脓肿等。其他并发症有迷路炎、面神经麻痹等。

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（2）慢性化脓性中耳炎 是指中耳黏膜、骨膜或深达骨质的慢性化脓性炎症。本病在临床上较为常见，常以耳内间断或持续性流脓、鼓膜穿孔、听力下降为主要临床表现，严重时可引起颅内、颅外的并发症。①全身症状 轻重不一。可有怕冷、发热、乏力、食欲减退。小儿全身症状较重，常伴呕吐、腹泻等消化道症状。鼓膜一旦穿孔，体温即逐渐下降，全身症状明显减轻。②耳痛 耳深部疼痛，逐渐加重。如搏动性跳痛或刺痛，可向同侧头部或牙齿放射。吞咽及咳嗽时耳痛加重，耳痛剧烈者夜不能眠，烦躁不安。鼓膜穿孔流脓后，耳痛顿减。③耳流脓 是本病的主要症状，可为黏液、黏脓或纯脓性。非危险型流脓较稀薄，无臭味。危险型流脓虽不多，但较稠，多为纯脓性，并伴有异臭味。④听力减退及耳鸣 开始感耳闷，继则听力渐降，伴耳鸣。耳痛剧者耳聋可被忽略。有些患者可伴眩晕，穿孔后耳聋反而减轻。⑤耳聋 轻重不一，因多是单耳发病，易被忽视。一般为传导性聋。

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2.非化脓性中耳炎 分泌性中耳炎。

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（1）听力下降 急性分泌性中耳炎大多可于感冒后、乘飞机下降或潜水时，出现听力下降，可有“自声增强”现象。慢性分泌性中耳炎患者耳聋的严重程度常有波动。压迫耳屏或头位改变时，听力可有所改善，中耳积液黏稠时，听力不会因为头位的变动而改变。儿童多无听力下降的主诉，表现为对父母的呼唤不理睬，注意力不集中，或看电视时要求过大的音量。

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（2）耳痛 急性分泌性中耳炎时可有轻微耳痛，慢性分泌性中耳炎多在继发感染时可出现耳痛。

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（3）耳内闷胀感或闭塞感。

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（4）耳鸣 一般不重，可为间歇性，当头部运动、打呵欠或擤鼻时可闻及气过水声。少数分泌性中耳炎患者还可出现耳内流水，但是持续时间甚短，仅为数小时或1天左右。

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（5）耳镜检查 急性期鼓膜周边有放射状血管纹。鼓膜紧张部内陷，表现为光锥缩短、变形或消失；锤骨柄向后、上方移位；锤骨短突外突明显。鼓室积液时鼓膜失去正常光泽，呈淡黄、橙红或琥珀色；慢性者鼓膜乳白色或灰蓝色，不透明。若分泌物为浆液性，且未充满鼓室，可透过鼓膜见到液平面，呈凹面向上的弧形线，透过鼓膜有时可见到气泡，咽鼓管吹张后气泡增多；若鼓室内积液多，则鼓膜外突，鼓膜活动度受限。

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检查

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1.鼓膜

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松弛部或全鼓膜内陷，表现为光锥缩短、变形或消失，锤骨柄向后、上移位，捶骨短突明显外突，前后皱襞夹角变小。鼓室积液时鼓膜失去正常光泽，呈单黄、橙红色或琥珀色，光锥变形或移位。慢性者可呈灰兰或乳白色，鼓膜紧张部有扩张的微血管，短突显比垩色，捶骨柄呈浮雕状。若液体为浆液性，且未充满鼓室，可透过鼓膜见到液平面。此液面状如弧形发丝，称为发状线，凹面向上。头位变动时，其与地面平行的关系不变。透过鼓膜有时尚可见到气泡，咽鼓管吹张后气泡可增多。鼓气耳镜检查，鼓膜活动受限。

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2.拔瓶塞声

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分别紧压耳屏后速放，双耳分别试验，患者自觉患耳有类似拔瓶塞时的声响。

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3.听力检查

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音叉试验及纯音乐听阀测试结果显示传导性聋。听力损失正负不一，重者可达40dB HL左右。听力障碍显著者，应行听性脑干反应和耳声发射检查，以确定是否对内耳产生影响。

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4.CT扫描

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可见中耳系统气腔有不同程度密度增高。

\n

 

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4月5号感觉耳朵闷去医院，给开了甲泼尼龙，头孢和滴鼻液，用了一星期没效果复查让我做穿刺，不太想做穿刺就开了点药，有克拉霉素缓释片，切诺，甲泼尼龙。吃了一星期耳闷差不多好了但是开始耳鸣，复查之后医生说做穿刺，结果没抽出来，说可能积液粘稠，让我吃两盒切诺。现在耳鸣非常严重，请问贾医生我这是神经性耳鸣吗，还是我鼓膜好了耳鸣就好了呢，拜托贾医生解答一下

","barId":"1376","topicTypeId":"2","topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1739,"score":0,"partCount":0,"replayCount":1,"publishStatus":1,"publishTime":1556098173337,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":1,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1556104817639,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"5efd19d4667311e9972100163e0462f1","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"w13685197308","password":"w13685197308","level":0,"nickName":"w13685197308","realName":null,"signName":null,"head":null,"phone":"15651717278","mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":5,"userType":2,"isPhoneBind":1,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":null,"cityId":null,"userLevel":0,"modifyNameCount":0},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"11831","isDel":0,"createAt":1516958892154,"createBy":"8b39c578b53311e7a3d800163e04584d","createName":"梅油油","updateAt":0,"updateBy":null,"updateName":null,"userId":"8b39c578b53311e7a3d800163e04584d","title":"专家为您解答中耳炎有哪些症状","content":"

很多疾病就其本身来说并不至于致命，但是其中危害往往严重时可导致性命。中耳炎这种常见疾病也是如此。很多小孩刚患上中耳炎没有及时的治疗，最后因患上脑炎而发生危险。所以及时的发现和治疗是最重要的。下面找良医网给读者介绍一下中耳炎有哪些症状。

 

 \"专家为您解答中耳炎有哪些症状\"

 

中耳炎是耳部危害非常巨大的疾病，一旦患上中耳炎疾病，大家一定要及时的采取措施，避免这种疾病错过最佳的治疗时期导致严重的后果。

 

1、小儿反映听力下降，听不清、耳鸣，耳膜有“咕噜咕噜”的声音。多为低调间歇性，如“劈啪”声，嗡嗡声及流水声等。当头部运动或打呵欠、擤鼻时，耳内可出现气过水声，有时会间断一下再次出现。

 

2、若是幼儿，就会表现为爱抓耳朵，伴随哭闹，特别是在晚上。

 

3、还有就是已经患有鼻窦炎的小儿，出现上面几种情况更须注意。

 

4、如果游泳后感觉到听力下降、耳内疼痛，需立即送往医院到医院诊治。

 

上面是给各位读者介绍的中耳炎的病症表现，如果您的孩子有以上的表现之一，家长一定都要认真的重视，中耳炎可大可小，初时会感觉听力下降，可能过两天才觉得耳痛，流鼻涕、打喷嚏等，若没注意及时治疗，没控制好的中耳炎则会变成中耳乳突炎，严重的再发展成脑炎，最严重的后果可能致命。


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儿童患了中耳炎之后应该用哪些治疗方法进行治疗呢?

\"儿童患了中耳炎之后应该用哪些方法进行治疗呢？\"

1、积极治疗上呼吸道病灶性疾病，如慢性鼻窦炎、慢性扁桃体炎。

 

2、药物治疗：单纯型以局部用药为主：可用抗生素水溶液或抗生素与类固醇激素类药物混合液，如0.25％氯霉素液、氯霉素可的松液、氧氟沙星滴耳液、聪聪滴耳油能治疗中耳炎及外耳道炎等预防复发达到根治。

 

3、局部用药注意事项：

①用药前先清洗外耳道及中耳腔内脓液，可用3％双氧水或硼酸水清洗，后用棉花签拭净或以吸引器吸尽脓液，方可滴药。

②脓量多时用水剂，量少时可用硼酸酒精。

 

4、滴耳法：病人取坐位或卧位，患耳朝上。将耳廓向后上方轻轻牵拉，向外耳道内滴入药液3～4滴。然后用手指轻按耳屏数次，促使药液经鼓膜穿孔流入中耳。数分钟后方可变换体位。注意滴耳药液应尽可能与体温接近以免引起眩晕。

 

5、鼓膜大穿孔影响听力，在干耳后2个月左右可行鼓膜修补术或鼓室成形术。

 

6、骨疡型中耳炎，引流通畅者，以局部用药为主，但应注意定期复查。引流不畅或疑有并发症者及胆脂瘤型中耳炎，应及早施行改良乳突根治术或乳突根治术，彻底清除病变，预防并发症。

具体还的到医院就医治疗。

 

   具体还的到医院就医治疗。


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急性化脓性中耳炎的症状有哪些呢？常见症状：鼓膜充血、鼓膜发红，耳后红肿、咽鼓管堵塞、耳痛、耳根部疼痛、耳内疼痛、耳溢液、耳道流脓、耳鸣、耳内发胀、耳聋、小儿发热

\"急性化脓性中耳炎的症状有哪些呢？\"

本病全身及局部症状较重，小儿多发。可有畏寒、发热，小儿常伴呕吐、腹泻等。耳痛剧烈，且持续时间较长。听力下降并可伴有耳鸣。鼓膜穿孔前后表现截然不同，一旦鼓膜发生穿孔，耳内脓液外泄，症状可得到缓解。

1.全身症状

鼓膜穿孔前，全身症状明显，可有畏寒、发热、倦怠、食欲减退等，小儿全身症状通常较成人严重，可有高热、惊厥，常伴呕吐、腹泻等消化道症状，鼓膜穿孔后，体温逐渐下降，全身症状明显减轻。

2.耳痛

为本病的早期症状。患者感耳深部钝痛或搏动性跳痛，疼痛可经三叉神经放射至同侧额、颞、顶部、牙或整个半侧头部，吞咽、咳嗽、喷嚏时耳痛加重，耳痛剧烈者夜不能寐，烦躁。婴幼儿则哭闹不休。一旦鼓膜出现自发性穿孔或行鼓膜切开术后，脓液向外宣泄，疼痛顿减。

3.耳鸣及听力减退

患耳可有搏动性耳鸣、听力逐渐下降。耳痛剧烈者，轻度的耳聋可不被患者察觉。鼓膜穿孔后听力反而提高。如病变侵入内耳，可出现眩晕和感音神经性聋。

4.耳漏

鼓膜穿孔后耳内有液体流出，初为浆液血性，以后变为黏液脓性乃至脓性。如分泌物量甚多，提示分泌物不仅来自鼓室，亦源于鼓窦、乳突。

如果您有以上症状，找良医网提醒您赶紧到正规医院进行治疗。

 

 

 


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中耳炎是一种常见的耳部疾病，多发于儿童，对人的生活会造成极大的影响。那么你知道中耳炎的发病原因是什么吗，中耳炎症状是什么呢，该怎么去治疗中耳炎呢，这些问题不仅是患者，也是很多人很关心的问题，下面我们就来一探究竟吧。

\"中耳炎临床症状是什么呢？\"


中耳炎是累及中耳(包括咽鼓管、鼓室、鼓窦及乳突气房)全部或部分结构的炎性病变，好发于儿童。可分为非化脓性及化脓性两大类。非化脓性者包括分泌性中耳炎、气压损伤性中耳炎等，化脓性者有急性和慢性之分。特异性炎症太少见，如结核性中耳炎等。


临床表现

1. 化脓性中耳炎

(1)急性化脓性中耳炎

由化脓性细菌感染引起的中耳炎症，其症状主要是耳痛、流脓。小儿的全身症状比成人明显，可有发热、呕吐等。严重的并发症有颅内并发症，如脑膜炎、脑脓肿等。其他并发症有迷路炎、面神经麻痹等。

(2)慢性化脓性中耳炎

2. 是指中耳黏膜、骨膜或深达骨质的慢性化脓性炎症。本病在临床上较为常见，常以耳内间断或持续性流脓、鼓膜穿孔、听力下降为主要临床表现，严重时可引起颅内、颅外的并发症。

3. 症状表现轻重不一，可有怕冷、发热、乏力、食欲减退。小儿全身症状较重，常伴呕吐、腹泻等消化道症状。鼓膜一旦穿孔，体温即逐渐下降，全身症状明显减轻。

4. 耳痛

耳深部疼痛，逐渐加重。如搏动性跳痛或刺痛，可向同侧头部或牙齿放射。吞咽及咳嗽时耳痛加重，耳痛剧烈者夜不能眠，烦躁不安。鼓膜穿孔流脓后，耳痛顿减。

耳流脓

是本病的主要症状，可为黏液、黏脓或纯脓性。非危险型流脓较稀薄，无臭味。危险型流脓虽不多，但较稠，多为纯脓性，并伴有异臭味。

听力减退及耳鸣

开始感耳闷，继则听力渐降，伴耳鸣。耳痛剧者耳聋可被忽略。有些患者可伴眩晕，穿孔后耳聋反而减轻。

耳聋

轻重不一，因多是单耳发病，易被忽视。一般为传导性聋。

非化脓性中耳炎

\"中耳炎临床症状是什么呢？\"

5.(1)听力下降

急性分泌性中耳炎大多可于感冒后、乘飞机下降或潜水时，出现听力下降，可有“自声增强”现象。慢性分泌性中耳炎患者耳聋的严重程度常有波动。压迫耳屏或头位改变时，听力可有所改善，中耳积液黏稠时，听力不会因为头位的变动而改变。儿童多无听力下降的主诉，表现为对父母的呼唤不理睬，注意力不集中，或看电视时要求过大的音量。

（2）耳痛

急性分泌性中耳炎时可有轻微耳痛，慢性分泌性中耳炎多在继发感染时可出现耳痛。闷胀或闭塞

（3）耳鸣

（4）一般不重，可为间歇性，当头部运动、打呵欠或擤鼻时可闻及气过水声。少数分泌性中耳炎患者还可出现耳内流水，但是持续时间甚短，仅为数小时或1天左右。

（5）耳镜检查

急性期鼓膜周边有放射状血管纹。鼓膜紧张部内陷，表现为光锥缩短、变形或消失;锤骨柄向后、上方移位;锤骨短突外突明显。鼓室积液时鼓膜失去正常光泽，呈淡黄、橙红或琥珀色;慢性者鼓膜乳白色或灰蓝色，不透明。若分泌物为浆液性，且未充满鼓室，可透过鼓膜见到液平面，呈凹面向上的弧形线，透过鼓膜有时可见到气泡，咽鼓管吹张后气泡增多;若鼓室内积液多，则鼓膜外突，鼓膜活动度受限。

\"中耳炎临床症状是什么呢？\"

希望找良医网专家的解答能帮到您



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