鼓膜置管术和腺样体消融术联合治疗小儿分泌性中耳炎的临床观察  

Efficacy of tympanostomy tube emplacement combined with nasal endoscopic adenoidectomy in the treatment of pediatric secretory otitis media and its influence on long-term hearing recovery

作　　者：周林路 叶刚[1] 邹杨[1] 陈炜[1] ZHOU Linlu;YE Gang;ZOU Yang;CHEN Wei(Department of Otolaryngology,Leshan People's Hospital,Leshan,Sichuan,614000,China)

机构地区：[1]四川省乐山市人民医院耳鼻咽喉科,614000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2023年第3期166-170,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的 探讨鼓膜置管术与鼻内镜下经口腺样体低温等离子消融术联合治疗小儿分泌性中耳炎的疗效及对远期听力恢复的影响。方法 将我院收治的78例儿童分泌性中耳炎患者,随机法将其分为对照组和试验组,每组各39例,对照组患儿使用采取单纯鼓膜置管术治疗,观察组采取鼓膜置管术与鼻内镜下腺样体切除术联合治疗。比较两组患儿治疗的总有效率、中耳积液吸收时间、近远期听力功能、术后并发症及疾病复发率。结果 观察组的治疗总有效率94.87%(37/39)明显高于对照组的79.49%(31/39)(P<0.05)。对照组患儿中耳积液吸收时间平均为(8.93±0.52)天,观察组患儿中耳积液吸收时间平均为(6.97±0.38)天,与对照组患儿相比,试验组患儿中耳积液吸收时间更短(P<0.05)。术后1个月、6个月、1年及3年复查患儿听力功能,两组患儿双耳高频平均听阈较手术前明显降低(P<0.05)。且观察组显著低于同一时间对照组(P<0.05)。两组患儿ABR阈值水平较手术前明显降低(P<0.05)。且观察组明显低于同一时间对照组(P<0.05)。术后1月,观察组患儿鼓膜切口感染率明显低于对照组(P<0.05);术后3年内,两组患儿出现鼓室硬化及粘连性中耳炎比较,差异无统计学意义(P>0.05)。两组患儿比较总并发症发生率差异无统计学意义(P>0.05)。术后3年,观察组疾病复发率明显低于对照组(P<0.05)。结论 对儿童SOM患者联合鼓膜置管术与鼻内镜下经口腺样体低温等离子消融术治疗,可缩短中耳积液吸收时间,降低术后感染发生风险,改善其远期听力,降低复发率,具有临床应用价值。Objective To investigate the efficacy of tympanostomy tube emplacement combination with nasal endoscopic adenoidectomy in the treatment of pediatric secretory otitis media(SOM)and its influence on long-term hearing recovery.Methods A total of 78 children with secretory otitis media admitted to the hospital were randomly divided into control group and experimental group according to the random number table method,with 39 cases in each group.The control group was treated with simple tympanostomy tube emplacement,and the experimental group was given tympanostomy tube emplacement combined with nasal endoscopic adenoidectomy.The total effective rate of treatment,middle ear effusion absorption time,short-and long-term hearing function,postoperative complications and disease recurrence rate were compared between the two groups of children.Results The total effective rate of treatment with 94.87%(37/39)in experimental group was significantly higher than 79.49%(31/39)in control group(P<0.05).The average absorption time of middle ear effusion was(8.93±0.52)days in control group and was(6.97±0.38)days in experimental group,and the absorption time of middle ear effusion in experimental group was shorter compared to control group(P<0.05).The hearing function of children was reviewed at 1 month,6 months,1 year and 3 years after surgery,and the average binaural high-frequency hearing threshold of the two groups of children was significantly reduced compared with that before surgery(P<0.05),and the hearing threshold was significantly lower in experimental group than that in control group(P<0.05).The ABR threshold level of the two groups of children was significantly lower than that before surgery(P<0.05),and the threshold level of experimental group was significantly lower than that of control group(P<0.05).At 2 weeks after surgery,the wound infection rate was significantly lower in experimental group compared with that in control group(P<0.05).There were no statistically significant differences between the two groups in terms

关 键 词：分泌性中耳炎 鼓膜置管术 腺样体低温等离子消融术 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]