内镜下低温等离子腺样体消融术联合鼓室置管术治疗分泌性中耳炎伴腺样体肥大患儿的效果  

Effects of endoscopic low temperature plasma adenoid ablation combined with tympanic catheterization in treatment of secretory otitis media with adenoid hypertrophy in children

作　　者：叶暴著 YE Baozhu(Department of Otorhinolaryngology of Shangcheng County People’s Hospital,Xinyang 465350 Henan,China)

机构地区：[1]商城县人民医院耳鼻咽喉科,河南信阳465350

出　　处：《中国民康医学》2024年第12期55-58,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察内镜下低温等离子腺样体消融术联合鼓室置管术治疗分泌性中耳炎(SOM)伴腺样体肥大(AH)患儿的效果。方法:选择2021年6月至2023年6月该院收治的72例SOM伴AH患儿进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各36例。两组均实施鼓室置管术治疗,在此基础上,对照组接受常规腺样体切除术治疗,观察组接受内镜下低温等离子腺样体消融术治疗。比较两组临床疗效,手术前后血清炎性因子[白细胞介素-2(IL-2)、白细胞介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)]水平、纯音听阈、生命质量[慢性中耳炎5项生命质量量表(COM-5)]评分,以及并发症发生率。结果:观察组治疗总有效率为97.22%(35/36),高于对照组的77.78%(28/36),差异有统计学意义(P<0.05);术后3个月,观察组血清IL-2、IL-10、TNF-α水平,纯音听阈,以及耳部症状、听力损伤、消极情绪、监护人担忧、日常活动受限等COM-5各项评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.78%(1/36),低于对照组的25.00%(9/36),差异有统计学意义(P<0.05)。结论:内镜下低温等离子腺样体消融术联合鼓室置管术治疗SOM伴AH患儿效果优良,能够减轻术后炎症反应,改善听力,提高生命质量,降低并发症发生率,效果优于常规腺样体切除术联合鼓室置管术治疗。Objective:To observe effects of endoscopic low temperature plasma adenoid ablation combined with tympanic catheterization in treatment of secretory otitis media(SOM)with adenoid hypertrophy(AH)in children.Methods:A prospective study was conducted on 72 children with SOM and AH admitted to this hospital from June 2021 to June 2023.According to the random number table method,they were divided into observation group and control group,36 cases in each group.Both groups were treated with tympanic catheterization.On this basis,the control group received conventional adenoidectomy,while the observation group received endoscopic low temperature plasma adenoid ablation.The clinical efficacy,the serum inflammatory factors[interleukin-2(IL-2),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)]levels,the pure tone hearing threshold and the quality of life[chronic otitis media outcome test(COM-5)]scores before and after the surgery,and the incidence of complications were compared between the two groups.Results:The total effective rate of the observation group was 97.22%(35/36),which was higher than 77.78%(28/36)of the control group,and the difference was statistically significant(P<0.05).3 months after the surgery,the levels of serum IL-2,IL-10,TNF-α,the pure tone hearing threshold,and the COM-5 scores of ear symptoms,hearing impairment,negative emotions,guardian concerns,and limited daily activities in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 2.78%(1/36),which was lower than 25.00%(9/36)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Endoscopic low temperature plasma adenoid ablation combined with tympanic catheterization is effective in the treatment of the children with SOM and AH.It can reduce the postoperative inflammatory response,improve the hearing conditions,improve the quality of life and reduce the incidence of comp

关 键 词：儿童 分泌性中耳炎 腺样体肥大 低温等离子消融术 鼓室置管 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]