两种不同入路鼻内镜下腺样体切除治疗儿童分泌性中耳炎比较  

Comparison of two different approaches of endoscopic adenoidectomy in the treatment of pediatric secretory otitis media

作　　者：马进[1] 刘毅[1] MA Jin LIU Yi(E.N.T. Department, Kunming First People＇s Hospital, Kunming 650000, Chin)

机构地区：[1]昆明市第一人民医院耳鼻喉科,云南昆明650000

出　　处：《中国现代医生》2017年第32期48-51,共4页China Modern Doctor

摘　　要：目的比较鼻内镜下经鼻与经口两种不同入路切除儿童腺样体治疗分泌性中耳炎的疗效评估与分析。方法选取昆明市第一人民医院2016年2月~2017年1月进行腺样体切除手术治疗分泌性中耳炎儿童73例分为两组,A组37例经鼻0°鼻内镜下腺样体切除,B组36例经口70°鼻内镜下腺样体切除,比较两组治疗效果、手术时间、术后并发症发生率及恢复时间。结果两组患者均顺利完成手术,A组痊愈23例(62.16%)、有效12例(32.43%)、无效2例(5.41%),B组痊愈22例(61.11%)、有效11例(30.56%)、无效3例(8.33%),两组疗效无统计学差异(P>0.05)。但A、B两组手术时间分别为(22.00±2.00)和(35.00±2.00)min,术后并发症发生率分别为10.81%和55.56%,恢复时间分别为(2.49±0.83)和(5.69±0.92)d,两组均有统计学差异(P<0.05)。结论鼻内镜下腺样体切除可有效治疗儿童分泌性中耳炎,经鼻入路内镜下腺样体切除较经口入路手术时间缩短,术后并发症较轻,恢复时间短。Objective To compare the efficacy evaluation and analysis of two different approaches of transnasal and transoral adenoidectomy under endoscopy in the treatment of secretoly otitis media. Methods A total of 73 children with secretory otitis media who were given adenoidectomy from February 2016 to January 2017 in Kunming First People＇s Hospital were selected and assigned to two groups. Group A of 37 patients was given transnasal adenoidectomy, and group B of 36 patients was given transoral adenoidectomy under 70° nasal endoscopy. The treatment effect, operation time, complications incidence rate and recovery time before and after the operation were compared between the two groups. Results The two groups of patients were successfully completed the operation. In group A, there were 23 eases recovered（62.16%）, 12 cases effective（32.43%）, and 2 cases ineffective（5.41%）. In group B, there were 22 cases recovered（61.11%）, 11 cases effective（30.56%）, and 3 cases ineffective（8.33%）. There was no statistically significant difference between the two groups（P〉0.05）. However, the operation time of group A and group B was（22.00±2.00）and （35.00±2.00）minutes respectively, the complications incidence rate was 10.81% and 55.56%, and the recovery time was （2.49±0.83）and（5.69±0.92）days. The three indexes were statistically different between the two groups（P〈0.05）. Conclusion Nasal endoscopic adenoidectomy can effectively treat pediatric secretory otitis media. The surgery time of transnasal endoscopic adenoidectomy is shorter than that of transoral approach, the postoperative complications are mild and the recovery time is short.

关 键 词：鼻内镜 腺样体肥大 分泌性中耳炎 儿童 

分 类 号：R766.9[医药卫生—耳鼻咽喉科] R764.21[医药卫生—临床医学]