鼻内镜下腺样体切除术联合鼓膜置管治疗小儿顽固性分泌性中耳炎的效果  

Effect of nasal endoscopic adenoidectomy combined with tympanic membrane catheterization in refractory secretory otitis media in children

作　　者：刘刚 张晓华 杨红 张青 常蕾 辛阳 LIU Gang;ZHANG Xiaohua;YANG Hong;ZHANG Qing;CHANG Lei;XIN Yang(Otolaryngology and Head and Neck Surgery Department,Changqing Oilfield Staff Hospital,Xi'an 710201;Otorhinolaryngology Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,China)

机构地区：[1]长庆油田职工医院耳鼻咽喉头颈外科,陕西西安710201 [2]西安市交通大学第二附属医院耳鼻喉科,陕西西安710000

出　　处：《临床医学研究与实践》2020年第26期8-9,12,共3页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2017KW-048)。

摘　　要：目的研究鼻内镜下腺样体切除术联合鼓膜置管治疗小儿顽固性分泌性中耳炎(RSOM)的效果。方法将我院收治的RSOM小儿150例(268耳)根据治疗方法不同分为对照组(70例,128耳)和观察组(80例,140耳)。对照组行鼻内镜下腺样体切除术,观察组在对照组基础上行鼓膜置管术。比较两组治疗效果。结果观察组治疗总有效率高于对照组(P<0.05)。术后1个月,两组ABR阈值和IL-6水平均明显降低,且观察组低于对照组(P<0.05)。观察组复发率低于对照组,并发症总发生率高于对照组(P<0.05)。结论鼻内镜下腺样体切除术联合鼓膜置管治疗RSOM的效果显著,术后复发率明显降低,患儿的听力恢复和炎症反应改善情况更为理想。Objective To study the effect of nasal endoscopic adenoidectomy combined with tympanic membrane catheterization in the treatment of refractory secretory otitis media(RSOM)in children.Methods A total of 150 children(268 ears)with RSOM admitted in our hospital were divided into control group(70 cases,128 ears)and observation group(80 cases,140 ears)according to different treatment methods.The control group underwent adenoidectomy under nasal endoscopic,and the observation group underwent tympanic membrane catheterization on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).One month after operation,ABR threshold and IL-6 level in the two groups reduced,and those of the observation group were lower than the control group(P<0.05).The recurrence rate of the observation group was lower than that of the control group,and the total incidence of complications was higher than that of the control group(P<0.05).Conclusion Nasal endoscopic adenoidectomy combined with tympanic membrane catheterization is effective in the treatment of RSOM,it has a significantly lower postoperative recurrence rate,and more ideal hearing recovery and inflammatory reaction improvement of children.

关 键 词：鼻内镜腺样体切除术 鼓膜置管 顽固性分泌性中耳炎 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]