咽鼓管测压在判断儿童分泌性中耳炎疗效及预后中的作用  

Role of Eustachian tube manometry in judging the curative effect and prognosis of secretory otitis media in children

作　　者：汪晓锋[1] 陈乌娜[1] 苏文玲[1] 林勤[1] 骆献阳[1] 蔡成福[1] WANG Xiaofeng;CHEN Wuna;SU Wenling;LIN Qin;LUO Xianyang;CAI Chengfu(Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of Xiamen University,Xiamen,Fujian,361000,China)

机构地区：[1]厦门大学附属第一医院耳鼻咽喉头颈外科,福建厦门361000

出　　处：《中国耳鼻咽喉头颈外科》2020年第4期222-224,228,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨咽鼓管测压(tubomanometry,TMM)对儿童分泌性中耳炎疗效及预后的评估价值.方法选取65例(88耳,其中单耳30例,双耳29例)就诊于我科的儿童分泌性中耳炎患者为实验组,以相应年龄儿童的正常耳(30耳)作为正常对照组,所有患者均行正规的药物治疗,根据治疗的效果分为有效组(65耳)和无效组(23耳).并分别在治疗前后进行纯音测听、声导抗、耳内镜及TMM测试同时记录结果.结果治疗前无论是有效组还是无效组咽鼓管评分(Eustachian tube scores,ETS)平均值均低于正常对照组(P<0.01);治疗后ETS平均值均高于治疗前(P<0.05);治疗前有效组ETS高于无效组(P<0.05);有效组治疗后ETS与正常对照组之间差别无统计学意义(P>0.05),无效组治疗后ETS仍低于正常对照组(P<0.01).结论分泌性中耳炎患者的咽鼓管功能均存在不同程度的障碍,经过治疗,咽鼓管功能改善.ETS较高的患者,经治疗,咽鼓管功能可以恢复;ETS较低者,短期内咽鼓管功能难以恢复,应尽快采取其他的干预措施恢复咽鼓管功能.咽鼓管测压在对儿童分泌性中耳炎的疗效及预后的判断中可提供一定的参考价值.OBJECTIVE To evaluate the value of tubomanometry in evaluation of efficacy and prognosis for children with secretory otitis media.METHODSSixty-five children(88ears) with secretory otitis media were selected as experimental group,30 children with single ear and 29 children with binaural otitis media.The normal 30 ears of children with corresponding age were the control.All patients were treated with a regular medication and were divided into an effective group(65 ears) and an invalid group(23 ears) according to the effect of treatment.Pure tone audiometric,acoustic immittance,Ear fiber endoscopy and TMM were performed before and after treatment,and the results were recorded.RESULTS The average value of ETS in both effective group and ineffective group was lower than that in normal control group before treatment(P<0.01),and the average value of ETS after treatment was higher than that before treatment(P<0.05).ETS in the effective group before treatment was higher than that in the ineffective group(P<0.05).There was no significant difference in ETS between the effective group and the normal control group after treatment(P>0.05),but the ETS in the ineffective group was still lower than that in the normal control group after treatment(P<0.05).CONCLUSION There are different degrees of disorders in eustachian tube function in patients with secretory otitis media.After treatment,eustachian tube function is improved.In patients with higher ETS,eustachian tube function can be recovered after treatment,while in patients with low ETS,it is difficult to recover eustachian tube function in a short period of time,so other intervention measures should be taken as soon as possible to restore eustachian tube function.Tubomanometry can be valuable for evaluating the treatment effect and prognosis of children with secretory otitis media.

关 键 词：儿童 中耳炎伴渗出液 咽鼓管测压 咽鼓管评分 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]