儿童分泌性中耳炎鼓膜置管术后通气管留置时间与疗效的关系及其影响因素分析  

Analysis of the relationship between the indwelling time of the ventilation tube and the therapeutic effect and its influencing factors after tympanic membrane catheterization in children with secretory otitis media

作　　者：敬尚林 余翔 贤耀军 胡江锋 杨艳 唐向荣 莫炼 温慧 覃麟婷 岑丽葵 欧艳红 JING Shanglin;YU Xiang;XIAN Yaojun;HU Jiangfeng;YANG Yan;TANG Xiangrong;MO Lian;WEN Hui;QIN Linting;CEN Likui;OU Yanhong(Department of Otolaryngology,Liuzhou Maternity and Child Healthcare Hospital,Liuzhou 545001,China;Department of Otolaryngology,Guangzhou Women and Children’s Medical Center Liuzhou Hospital,liuzhou 545006,China)

机构地区：[1]柳州市妇幼保健院耳鼻咽喉科,广西柳州545001 [2]广州市妇女儿童医疗中心柳州医院耳鼻咽喉科,广西柳州545006

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第5期98-102,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：广西卫生健康委员会自筹经费科研课题(Z-B2021581)。

摘　　要：目的分析儿童分泌性中耳炎(SOM)鼓膜置管术后通气管留置时间与疗效的关系及其影响因素。方法对115例(183耳)行鼓膜置管术患儿的临床诊疗和随访资料进行回顾性分析。结果115例(183耳)行鼓膜置管术时的平均年龄为(4.68±2.54)岁,多集中在3.5~7岁,占86.57%。183耳术后通气管留置时间为3~18个月,平均留置时间为(9.43±3.82)个月。痊愈耳(126耳)通气管留置时间平均为(11.82±3.11)个月,未愈耳(57耳)通气管留置时间平均为(9.13±3.21)个月,两者之间差异经比较具有统计学意义(P<0.01);留置时间<6个月者痊愈率为51.92%,≥6个月者痊愈率为75.57%,两者之间差异经比较具有统计学意义(P<0.05)。单因素卡方分析鼓膜显著塌陷或菲薄、通气管堵塞、术后中耳感染、术后早期活动等因素与鼓膜置管术后通气管早期脱落相关(P<0.05);多因素Logistic回归分析,发现手术时鼓膜重度塌陷或菲薄、术后通气管堵塞、术后中耳感染、术后不按时复查、术后早期较强活动是儿童鼓膜置管术后通气管早期脱落的独立危险因素(P<0.05)。结论鼓膜置管术后通气管过早脱管或取管,影响SOM患儿治愈率。鼓膜重度塌陷或菲薄、术后通气管堵塞、术后中耳感染、术后不按时复查、术后早期较强活动是主要危险因素,临床上应予以重视。Objective To analyze the relationship between the indwelling time of the ventilation tube and the curative effect after tympanectomy for secretory otitis media(SOM)in children,and to analyze the risk factors of early exfoliation after eardrum catheterization in children with SOM.Methods It was retrospectively analyzed for the clinical diagnosis,treatment and follow-up data of 115 cases(183 ears)with tympanic membrane catheterization.Results The 115 children(183 ears)underwent tympanic membrane intubation at the average age of(4.68±2.54)years old,and the majority(86.57%)at 3.5 to 7 years old.The indwelling time of ventilation tube in 183 ears after operation was 3 to 18 months,and the average indwelling time was(9.43±3.82)months,the average time of tracheal indwelling in 126 cured ears was(11.82±3.11)months,and that in 57 untreated ears was(9.13±3.21)months.The difference between them was statistically significant(P<0.01).The recovery rate of patients with retention time<6 months was 51.92%,and that of patients with retention time≥6 months was 75.57%.There was statistically a difference between them(P<0.05).These single factors,such as significant collapse or thinning of the tympanic membrane,obstruction of the ventilation tube,postoperative middle ear infection,and early postoperative activity were associated with the early fall of the ventilation tube after tympanic membrane intubation(P<0.05)by single-factor chi-square analysis;Multivariate logistic regression analysis showed that intraoperative severe collapse or a thin tympanic membrane,postoperation blockage of ventilation tube,middle ear infection,delayed re-examination and early strong activity were independent risk factors for early fall of ventilation tube after tympanic membrane intubation in children(P<0.05).Conclusions After tympanic membrane intubation,the ventilation tube was prematurely removed or removed,which could affect the cure rate of SOM children.Severe collapse or a thin tympanic membrane,postoperation blockage of the ventilation tube

关 键 词：中耳炎 分泌性 鼓膜置管术 留置时间 疗效 脱落 影响因素 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]