腺样体切除联合置管术在小儿难治性分泌性中耳炎治疗中的应用研究  

Applied research on adenoidectomy combined with catheterization in the treatment of children with refractory secretory otitis media

作　　者：李瑾[1] 李幼瑾[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心耳鼻咽喉科,上海200127

出　　处：《中国妇幼健康研究》2016年第3期326-328,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨腺样体切除联合置管术应用于小儿难治性分泌性中耳炎的治疗效果。方法选取上海交通大学医学院附属上海儿童医学中心2012年4月至2014年2月间入院治疗的小儿难治性分泌性中耳炎患者90例,应用随机数袁法随机分为观察组45人和对照组45人。对照组使用低温等离子腺样体切除术;观察组则应用腺样体切除联合置管术治疗。统计两组患者治疗效果、炎性积液及并发症情况,按显效、有效和无效来评价患儿临床疗效,记录并统计参与试验患儿中耳炎性积液时间和听力损失、鼓膜穿孔等并发症情况。结果临床疗效方面,观察组和对照组的治疗总有效率分别为91.11%和73.33%,两组差异具有统计学意义(x^2=8.631,P<0.05)。观察组患儿中耳积液时间为7.63±1.27天短于对照组的11.78±1.75天,差异具有铳计学意义(t=3.481,P<0.05)。观察组治疗后中耳炎复发的比例(2.22%)比对照组(42.22%)低,差异具有统计学意义(x^2=9.165,P<0.05)。两组并发症发生率分别为8.88%和40.00%,患儿鼓膜穿孔、化脓性中耳炎和听力损失等方面较对照组发生数明显更少,差异具有统计学意义(x^2=8.186,P<0.05)。结论腺样体切除联合置管术能够有效治疗小儿难治性分泌性中耳炎,改善临床症状,提高治疗有效率,应用效果良好,值得临床推广。Objective To explore the therapeutic effects of adenoidectomy combined with catheterization in the treatment of children with refractory secretory otitis media （SOM）. Methods A total of 90 cases of pediatric patients with refractory SOM were selected. All those patients were hospitalized and received treatments at Shanghai Children＇ s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from April 2012 to February 2014. They were randomly divided into observation group （ n = 45 ） and control group （ n = 45 ） in accordance with random number table. Patients in the control group received conventional adenoidectomy assisted by low temperature plasma while patients in the observation group received adenoidectomy combined with catheterization. Therapeutic effects, status of inflammatory effusion and complications of patients in both groups were recorded. Besides, clinical effects were classified as effectual, effective and non-effective to evaluate preceding treatments. In addition, occurrences of complications like inflammatory effusion, loss of hearing and tympanic membrane perforation were also recorded. Results In terms of clinical effect, the total effective rate of both groups was 91.11% and 73.33% , respectively. The preceding difference was of statistical significance （χ^2 = 8.631, P 〈 0.05 ）. As for patients in the observation group, the duration of inflammatory effusion lasted 7.63 ±1.27 days, which was shorter than that in the control group （ 11.78 ± 1.75 days）. The preceding difference was statistically significant （ t = 3. 481, P 〈 0.05 ）. The ratio of post-treatment otitis media reoccurrence was 2.22% in the observation group, which was lower than 42.22% in the control group. The preceding difference was of statistical significance （χ^2 = 9. 165, P 〈 0.05 ）. The incidence of complications was 8.88% and 40.00% , respectively. The observation group had fewer occurrences of tympanic membrane perforation, suppurative otitis meadia and loss of he

关 键 词：腺样体切除术 置管术 小儿 难治性分泌性中耳炎 应用研究 

分 类 号：R726.1[医药卫生—儿科]