顽固性分泌性中耳炎及其后遗症经手术治疗的效果分析  

Analysis of the Effect of Surgical Treatment on Persistent Secretory Otitis Media and Its Sequelae

作　　者：王嘉麟 林佳怡 WANG Jialin;LIN Jiayi(Huizhou Central People’s Hospital,Huizhou 516001,China;不详)

机构地区：[1]惠州市中心人民医院,广东惠州516001

出　　处：《中外医学研究》2021年第36期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2020年东莞市社会科技发展(一般)项目(202050715024893)。

摘　　要：目的:研究顽固性分泌性中耳炎及其后遗症经手术治疗的效果。方法:选取2018年1月-2020年1月惠州市中心人民医院收治的顽固性分泌性中耳炎及后遗症患者80例。所有受试者均接受完璧式乳突切除术治疗。分析80例患者术中所见和病理检查结果,术后情况,随访12个月,分析术前及术后12个月咽鼓管功能评分(ETS)、平均听阈(PTA)及气骨导差(ABG)变化情况及鼓室图检查结果。结果:病理结果显示29例鼓室黏膜肿胀不一,且鼓室之中出现黏液或胶冻样分泌物;41例存在鼓膜与鼓室的粘连;49例出现中上鼓室的受限;21例鼓室有肉芽组织;42例出现不同程度的咽鼓管阻塞。71例获得痊愈,未发生鼓膜形态异常和/或耳溢液,术后复发9例,再次入院后实施开放式乳突切除联合鼓膜置管术,均得以痊愈。80例患者术后12个月的ETS为(6.87±1.12)分,明显高于术前的(2.07±0.42)分,而PTA及ABG分别为(18.09±2.55)、(5.19±1.05)dBHL,均明显低于术前的(35.93±4.07)、(28.25±4.62)dBHL,差异均有统计学意义(P<0.05)。术后12个月患者鼓室图分级为A级的人数占比明显高于术前,而C级人数占比明显低于术前(P<0.05)。结论:顽固性分泌性中耳炎及其后遗症经手术治疗后可获得较为理想的临床效果,有助于患者听力的恢复及临床症状的改善,值得临床推广应用。Objective:To study the effect of surgical treatment on persistent secretory otitis media and its sequelae.Method:A total of 80 patients with persistent secretory otitis media and its sequelae admitted to Huizhou Central People’s Hospital from January 2018 to January 2020 were selected.All subjects received complete mastoidectomy treatment.The intraoperative observation and pathological examination results,postoperative conditions of 80 patients were analyzed,they were followed up for 12 months,the changes of eustachian tube function score(ETS),pure tone average(PTA),air bone conductance(ABG)before and 12 months after operation and tympanogram examination results were analyzed.Result:Pathological results showed that 29 cases of tympanic mucosa swelling,and there were mucus or gelatinous secretions in the tympanic room.There were adhesion between tympanic membrane and tympanic room in 41 cases.Limitation of middle superior tympanic room in 49 cases,granulation tissue in tympanic room was found in 21 cases.Different degrees of eustachian tube obstruction occurred in 42 cases.A total of 71 cases were cured without abnormal tympanic membrane morphology or ear discharge,and 9 cases recurred after operation.After re-admission,mastoidectomy combined with tympanic membrane catheterization was performed,and all of them were cured.In the 80 patients,the ETS at 12 months after operation was(6.87±1.12)points,which was significantly higher than(2.07±0.42)points before operation,while the PTA and ABG were(18.09±2.55)and(5.19±1.05)dBHL respectively,which were significantly lower than(35.93±4.07)and(28.25±4.62)dBHL before operation,the differences were statistically significant(P<0.05).Twelve months after surgery,the proportion of patients with grade A tympanogram was significantly higher than that before surgery,while the proportion of patients with grade C was significantly lower than that before surgery(P<0.05).Conclusion:Surgical treatment for persistent secretory otitis media and its sequelae can obtain a relatively

关 键 词：顽固性分泌性中耳炎 后遗症 手术治疗 开放式乳突切除 完璧式乳突切除 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]