2种手术方式治疗儿童分泌性中耳炎的疗效对比分析  

The comparison of efficacy of two patterns of surgery for children with secretory otitis media

作　　者：范宇琴[1] 冯娟[1] 阳玉萍[1] 阿依恒.曲库尔汗[1] 雍军[1] 胡斌[1] 张华[1] 

机构地区：[1]新疆医科大学第一附属医院耳鼻喉科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2015年第8期996-998,共3页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(30860310)

摘　　要：目的探讨2种手术方式治疗儿童分泌性中耳炎的临床效果及2种手术方式的优缺点。方法选取新疆医科大学第一附属医院耳鼻喉科2014年1-6月收治的50例中耳炎患儿,分为经鼻组和经口组,分别采用鼻内镜下经鼻、经口切除腺样体治疗,比较两组的手术疗效、术后并发症以及各频率听阈变化情况。结果两组治疗后在250、500、1 000 Hz频率的听阈均较治疗前明显上升,差异有统计学意义（P〈0.05）,治疗后听阈有所改善。经口组有效率明显高于经鼻组。随访3~6个月,经鼻组术后并发症总发生率最高（28.5%）,经口组仅有1例发生听力下降（4.3%）,但两组并发症发生率差异无统计学意义（χ2=1.556,P〉0.05）。结论 2种术式治疗儿童分泌性中耳炎疗效满意,并发症发生少。经鼻内镜腺样体切除具有手术效果好、对患者损伤小、并发症少的优点,经口内镜下腺样体切除效果优于经鼻治疗,首选经口内镜下腺样体切除术治疗腺样体肥大术式。Objective To investigate the clinical effects of two different surgical treatment on children with secretory otitis media,and compare the advantages and disadvantages of these two kinds of surgical procedures. Methods We chose 50 cases of otitis media in children from January 2014 to June 2014,from the Otolaryngology Department in The First Affiliated Hospital of Xinjiang Medical University. The patients undertook adenoidectomy through nasal（ nasal group） and oral（ oral group） respectively. Each group had 3 months＇ follow-up,and the surgery effect,postoperative complications,as well as the frequency of changes in hearing threshold in each group were compared. Results After treatment,hearing threshold at 250,500,1 000 Hz frequency was significantly increased compared with that before the treatment in both groups,the difference was statistically significant（P〈0. 05）. The efficiency of oral group was significantly higher than that of the nasal group. After 3 to 6 months follow-up,overall incidence of complications in nasal group was 28. 5%,while in oral group there was only 1 case of hearing loss,accounting for 4. 3%. However,the incidence of complications in the two groups showed no significant difference（ χ2= 1. 556,P〉0. 05）. Conclusion The outcome of two kinds of surgical procedures in the treatment of children with secretory otitis media was satisfactory,and nasal endoscopic adenoidectomy surgery has good effect,causing less damage and fewer complications. In oral endoscopic under adenoidectomy had better effect than nasal treatment,therefore,oral endoscopic adenoidectomy is the preferred surgical treatment for adenoid hypertrophy.

关 键 词：分泌性中耳炎 腺样体切除 鼻内镜 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]