分泌性中耳炎行鼓膜置管术前后畸变产物耳声发射变化及其与疗效关系  

DPOAE changes in secretory otitis media before and after tympanostomy tube insertion and their relationship with curative effect

作　　者：祝青萍 侯红岭 曹会玲 ZHU Qingping;HOU Hongling;CAO Huiling(Department of Otolaryngology,People＇s Hospital of Chengwu County,Chengwu,Shandong,274200,China)

机构地区：[1]山东省成武县人民医院耳鼻咽喉科,山东成武274200

出　　处：《中国耳鼻咽喉头颈外科》2018年第10期526-529,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨分泌性中耳炎(secretoryotitis media,SOM)手术治疗前后畸变产物耳声发射(DPOAE)变化及其与疗效的关系。方法选取2010年8月～2017年8月在我院就诊,经临床确诊SOM患儿120例为研究对象,所有SOM患儿全麻下常规行鼓膜穿刺加置管术治疗。术后第1天和第3周再次复查DPOAE、纯音听阈,与术前比较。结果(1)120例SOM患儿鼓膜穿刺均抽出少许鼓室积液,胶冻样积液65耳,黏液样积液42耳,浆液样积液13耳。(2)SOM组患儿置管前DPOAE引出率较正常对照组明显下降;置管后1天与置管后3周比较,各频率DPOAE引出率逐渐提高;置管后3周DPOAE引出率仍低于正常对照组。553、783、1105、1560、2211、3125和4416 Hz各频率两者分别比较,差异均有统计学意义(P均<0.05)。6250和8837 Hz频率的DPOAE引出率,置管前与正常对照组比较,置管后第1天与置管后3周比较,置管后3周与正常对照组比较,差异均无统计学意义(P>0.05)。(3)DPOAE幅值在SOM组患儿置管前、置管后1天和置管后3周逐渐接近正常对照组。但SOM组患儿置管后3周DPOAE幅值仍低于正常对照组。DPOAE幅值在553、783、1105、1560、2211、3125和4416 Hz各频率分别与正常对照组比较,差异均有统计学意义(P均<0.05)。频率为6250 Hz和8837 Hz的DPOAE幅值在置管前、置管后第1天、置管后3周分别与正常对照组比较,差异均无统计学意义(P>0.05)。(4)所有患儿术后第1天和术后3周的言语频率区(500、1000和2000 Hz)气导平均阈值与术前比较降低(P<0.05)。结论 SOM患儿接受鼓膜穿刺加置管术治疗后3周内DPOAE引出率和幅值均显著提高,治疗效果好。OBJECTIVE To investigate the change of distortion product otoacoustic emission（DPOAE） before and after surgical treatment of secretory otitis media（SOM） and its relationship with curative effect. METHODS A total of 120 children diagnosed with SOM between August 2010 to August 2017 were selected as subjects. All children with SOM were treated by tympanostomy tube insertion under general anesthesia. The DPOAE and pure tone hearing threshold were reexamined on the first and second postoperative day after treatment and compared with that of preoperative examination. R E S U LT S 1. 120 SOM effusions were collected from the tympanic cavity, of which, jelly-like effusion in 65 ears, mucinous effusion 42 ears, and serous effusion 13 ears. 2. The rate of DPOAE elicitation in SOM group was significantly lower than that in normal control group before intubation; 1 day after intubation the rate of DPOAE elicitation increased gradually until 3 weeks after intubation; 3 weeks after intubation, the rate of DPOAE elicitation was still lower than that of the normal control group, and the differences were statistically significant（P〈0.05）. The difference in the rate of DPOAE elicitation at frequencies of 6250 and 8837 Hz was not statistically significant（P〉0.05） between preintubation and the normal control group, so was the difference between first day after intubation and 3 weeks after intubation. 3. The DPOAE amplitude in SOM group was significantly lower than that of normal control group before intubation, 1 day after intubation, and 3 weeks after intubation; the DPOAE amplitude gradually increased. Three weeks after catheterization, the DPOAE amplitude was still lower than that of the normal control group, the differences were statistically significant（P〈0.05）. When compared with the normal control group, the amplitudes of DPOAE at 6250 Hz and 8837 Hz were not statistically significant before intubation, 1 day after and 3 weeks after intubation（P〉0.05）. 4. Allaverage threshold of air conduction

关 键 词：中耳炎 伴渗出液 儿童 鼓膜穿刺术 置管术 畸变产物耳声发射 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]