二氧化碳激光鼓膜造孔术在成人分泌性中耳炎中的疗效分析  

Analysis on the therapeutic efficacy of carbon dioxide laser tympanostomy in the treatment of adult otitis media with effusion

作　　者：曾薇[1] 陈美珍[1] 傅敏仪[1] 叶飞[1] 陈嵘 ZENG Wei;CHEN Meizhen;FU Minyi;YE Fei;CHEN Rong(Department of Otolaryngology Head and Neck Surgery,Zhongshan Hospital Affiliated to Sun Yat-sen University,Guangdong,Zhongshan 528403,China)

机构地区：[1]中山大学附属中山医院耳鼻咽喉头颈外科,广东中山528403

出　　处：《中国医药科学》2021年第8期221-224,共4页China Medicine And Pharmacy

基　　金：广东省中山市医学科研项目(2017J040)。

摘　　要：目的观察二氧化碳(CO2)激光鼓膜造孔术与鼓膜置管术治疗成人分泌性中耳炎的疗效。方法回顾性分析2017年1月至2019年10月在中山大学附属中山医院耳鼻咽喉头颈外科住院治疗的85例成人分泌性中耳炎患者,按治疗方法不同分为激光组(n=42)和置管组(n=43)。比较两种手术方法的有效率及并发症发生率。结果术后6个月激光组及置管组总有效率比较,差异有统计学意义(P<0.05),置管组总有效率更高;两组耳漏发生率及复发率比较,差异有统计学意义(P<0.05),激光组耳漏发生率低于置管组,复发率高于置管组,而两组的鼓膜穿孔、鼓膜瘢痕发生率比较,差异无统计学意义(P>0.05)。结论CO2激光鼓膜造孔术仅是一种短期通气的有效途径,对于有复杂病因的成人分泌性中耳炎,其咽鼓管功能障碍不可逆转,CO2激光鼓膜造孔术有效率不及鼓膜置管术,且复发率更高,不能替代鼓膜置管术。Objective To observe the therapeutic efficacy of carbon dioxide(CO2)laser tympanostomy and tympanic membrane catheterization in the treatment of adult otitis media with effusion.Methods A total of 85 cases of adult otitis media with effusion hospitalized in the Department of Otolaryngology Head and Neck Surgery of Zhongshan Hospital Affiliated to Sun Yat-sen University from January 2017 to October 2019 were analyzed retrospectively.They were divided into the laser group(n=42)and the catheter group(n=43)according to the treatment methods.The effective rate and incidence of complications of the two surgical methods were compared.Results 6 months after surgery,the total effective rate in the catheter group was higher than that in the laser group,with statistically significant difference(P<0.05).The incidence of otorrhea in the laser group was lower than that in the catheter group,while the relapse rate in the laser group was higher than that in the catheter group,with statistically significant differences(P<0.05).However,there were no statistically significant differences in tympanic membrane perforation and tympanic membrane scar between the two groups(P>0.05).Conclusion CO2 laser tympanostomy is just an effective way for short-term ventilation.For adult otitis media with effusion with complex etiology,the dysfunction of eustachian tube is irreversible.CO2 laser tympanostomy is less effective than tympanic membrane catheterization,and its relapse rate is higher,so it cannot replace tympanic membrane catheterization.

关 键 词：分泌性中耳炎 成人 CO2激光鼓膜造孔术 鼓膜置管术 

分 类 号：R739.63[医药卫生—肿瘤]