重庆医学2017，Vol.46Issue(15)：2041-2044,4.DOI:10.3969/j.issn.1671-8348.2017.15.009
鼓膜置管或鼓膜穿刺对腺样体切除治疗儿童分泌性中耳炎的影响
Effect of tympanostomy tube insertion or tympanocentesis on transnasal endoscopic adenoidectomy in the treatment of pediatric patients with secretory otitis media
摘要
Abstract
Objective To discuss the tympanic membrane puncture or tympanostomy tube under endotoscope combined with adenoidectomy under nasal endoscopy on the influence of invalid conservative treatment of pediatric secretory otitis media.Methods A total of 112 cases of secretory otitis media with invalid conservative treatment were selected in the department of otorhinolaryngology of children′s hospital of Nanjing Medical University from July 2013 to August 2015.They were divided into three groups,the group A of 38 cases(68 ears)underwent transnasal endoscopic pure adenoidectomy;the group B of 37 cases(60 ears)underwent transnasal endoscopic adenoidectomy combined with tympanocentesis;the group C of 37 cases(59 ears)underwent tympanostomy tube insertion.The clinical treatment effect,the period of middle ear effusion,postoperative recurrence and complication were observed and compared.Results The total effective rate of the 3 groups was improved after 3 months(P<0.05);the total effective rate in group B and group C at one week and 3 months after operation were higher than those of group A(P<0.05);and the total effective rate in group C at 3 months after operation was significantly higher than that of group B(P<0.05).The level of auditory brainstem evoked potential(ABR)and the latency of ABR wave Ⅰ latency were decreased at 1 year after operation(P<0.05);the ABR changes in group B and group C at 1 week and 1 year after operation were lower than those in group A(P<0.05).The incidence of recurrence rate and the period of middle ear effusion in group C were lower than those in group A and B(P<0.05).The incidence of complication of group A was lower than those of group B and group C(P<0.05).Conclusion Using tympanostomy tube combined with adenoidectomy under endoscope can improve the children with hearing,which not only can shorten the time of the middle ear effusion,but also effectively reduce the recurrence rate.关键词
中耳炎,伴渗出液/腺样体切除术/鼓膜/导管插入术/鼓膜置管/鼓膜穿刺/鼻内窥镜Key words
otitis media with effusion/adenoidectomy/tympanic membrane/catheterization/tympanostomy tube insertion/tympanocentesis/nasal endoscopy分类
医药卫生引用本文复制引用
朱珠,郑国玺,李琦,石秋兰,周洪根,方如平..鼓膜置管或鼓膜穿刺对腺样体切除治疗儿童分泌性中耳炎的影响[J].重庆医学,2017,46(15):2041-2044,4.基金项目
国家自然科学基金资助项目(81271068) （81271068）
高等学校博士学科点专项科研基金资助项目(20120201110060) （20120201110060）
南京市医学科技发展专项资金资助项目(YKK13134) （YKK13134）
南京医科大学科技发展基金资助项目(2012NJMU059). （2012NJMU059）
