耳内镜下鼓膜置管术中置入T型与哑铃型中耳通气管治疗儿童分泌性中耳炎的效果比较  

Comparison of effect of T-tube and dumbbell-shaped tube placement for middle ear ventilation in otoendoscopic tympanostomy for secretory otitis media in children

作　　者：陈晓华[1] Chen Xiaohua(Department of Ear Microsurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院耳显微外科,郑州450000

出　　处：《中国实用医刊》2024年第15期26-29,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较耳内镜下鼓膜置管术中置入T型与哑铃型中耳通气管治疗儿童分泌性中耳炎的临床效果。方法队列研究。抽取2022年1月至2023年1月郑州大学第一附属医院收治的97例分泌性中耳炎患儿,均行耳内镜下鼓膜置管术治疗,根据术中置入的中耳通气管将其分为A组(49例,术中置入硅胶T型中耳通气管)和B组(48例,术中置入钛质哑铃型中耳通气管)。比较两组治愈率、鼓室图、听力学指标[气导听阈、骨导听阈及气骨导差]、术后并发症及复发率。结果两组整体治愈率、浆液型积液患儿治愈率比较,差异未见统计学意义(P>0.05);A组黏液型积液患儿治愈率高于B组(P<0.05)。术后,两组鼓室图A型占比多于术前,B、C型占比少于术前(P<0.05),但组间比较差异未见统计学意义(P>0.05)。术后,两组气导听阈、骨导听阈、气骨导差低于术前(P<0.05),但组间比较差异未见统计学意义(P>0.05)。A组术后并发症发生率及复发率低于B组(P<0.05)。结论对于鼓室积液性状为浆液型的分泌性中耳炎患儿,鼓膜置管术中置入硅胶T型中耳通气管与钛质哑铃型中耳通气管的效果相近,但对于鼓室积液性状为黏液型的分泌性中耳炎患儿,硅胶T型中耳通气管效果更好,且硅胶T型中耳通气管并发症更少。Objective To compare the clinical efficacy of T-tube and dumbbell-shaped tube placement for middle ear ventilation in otoendoscopic tympanostomy for secretory otitis media in children.Methods A total of 97 children with secretory otitis media treated by otoendoscopic tympanostomy in the First Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were selected for the cohort study.And they were divided into group A(49 cases,implanted with silicone T-tube for middle ear ventilation)and group B(48 cases,implanted with dumbbell-shaped tube for middle ear ventilation)according to tube used for middle ear ventilation during surgery.The cure rate,tympanogram,audiological indexes,including air-conduction hearing threshold,bone-conduction hearing threshold and air-bone gap,postoperative complications,and recurrence rates were compared between the two groups.Results There was no significant difference in the overall cure rate and the cure rate of children with serous effusion between the two groups(P>0.05).The cure rate of children with mucinous effusion in group A was higher than that in group B(P<0.05).After surgery,the proportions of tympanogram type A in the two groups were higher than those before operation,and the proportions of type B and type C in the two groups were less than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).After surgery,the air-conduction hearing threshold,bone-conduction hearing threshold and air-bone gap in the two groups were lower than those before surgery(P<0.05),but there was no significant difference in the above indexes between the two groups(P>0.05).The incidence of postoperative complication and recurrence rate of group A were lower than those of group B(P<0.05).Conclusions For children with otitis media complicated by serous effusion,silicone T-tube for middle ear ventilation and titanium dumbbell-shaped tube for middle ear ventilation has comparable effects during tympanostomy.However,for children with otitis

关 键 词：分泌性中耳炎 鼓膜置管术 T型中耳通气管 哑铃型中耳通气管 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]