耳内镜下鼓膜置管术联合腺样体切除术在药物治疗无效的儿童分泌性中耳炎治疗中的应用价值
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摘要
目的研究耳内镜下鼓膜置管术联合腺样体切除术在药物治疗无效的儿童分泌性中耳炎治疗中的应用价值。方法随机选取2015年9月至2018年10月我院药物治疗无效的分泌性中耳炎患儿62例(103耳)为研究对象,将其随机分为单独治疗组(31例,51耳)和联合治疗组(31例,52耳)。单独治疗组采用耳内镜下鼓膜置管术进行治疗,联合治疗组采用耳内镜下鼓膜置管术联合腺样体切除术进行治疗。分析两组患儿的临床疗效、中耳积液时间、复发情况及术后并发症发生情况。结果联合治疗组患儿的治疗总有效率显著高于单独治疗组,差异具有统计学意义(P<0.05)。联合治疗组患儿的中耳积液时间显著短于单独治疗组,复发率显著低于单独治疗组,差异具有统计学意义(P<0.05)。联合治疗组患儿的术后并发症总发生率显著低于单独治疗组,差异具有统计学意义(P<0.05)。结论耳内镜下鼓膜置管术联合腺样体切除术治疗在药物治疗无效的儿童分泌性中耳炎治疗中的应用价值较单独耳内镜下鼓膜置管术治疗高,值得在临床推广应用。
Objective To study the application value of endoscopic tympanic membrane catheterization combined with adenoidectomy in the treatment of secretory otitis media in children with ineffective drug treatment. Methods Sixty-two children(103 ears) with secretory otitis media with ineffective drug treatment in our hospital from September 2015 to October 2018 were randomly selected as the study objects and randomly divided into single treatment group(31 cases, 51 ears) and combined treatment group(31 cases, 52 ears). The single treatment group was treated with endoscopic tympanic membrane catheterization,while the combined treatment group was treated with endoscopic tympanic membrane catheterization combined with adenoidectomy. The clinical efficacy, time of middle ear effusion, recurrence and complications between the two groups were analyzed. Results The total effective rate of treatment in the combined treatment group was significantly higher than that of the single treatment group, and the difference was statistically significant(P<0.05). The time of middle ear effusion in the combined treatment group was significantly shorter than that in the single treatment group, and the recurrence rate was significantly lower than that in the single treatment group, the differences were statistically significant(P<0.05). The total incidence of postoperative complications in the combined treatment group was significantly lower than that in the single treatment group, and the difference was statistically significant(P<0.05). Conclusion Endoscopic tympanic membrane catheterization combined with adenoidectomy is more valuable than endoscopic tympanic membrane catheterization alone in the treatment of secretory otitis media in children with ineffective drug treatment, which is worthy of clinical promotion and application.
Objective To study the application value of endoscopic tympanic membrane catheterization combined with adenoidectomy in the treatment of secretory otitis media in children with ineffective drug treatment. Methods Sixty-two children(103 ears) with secretory otitis media with ineffective drug treatment in our hospital from September 2015 to October 2018 were randomly selected as the study objects and randomly divided into single treatment group(31 cases, 51 ears) and combined treatment group(31 cases, 52 ears). The single treatment group was treated with endoscopic tympanic membrane catheterization,while the combined treatment group was treated with endoscopic tympanic membrane catheterization combined with adenoidectomy. The clinical efficacy, time of middle ear effusion, recurrence and complications between the two groups were analyzed. Results The total effective rate of treatment in the combined treatment group was significantly higher than that of the single treatment group, and the difference was statistically significant(P<0.05). The time of middle ear effusion in the combined treatment group was significantly shorter than that in the single treatment group, and the recurrence rate was significantly lower than that in the single treatment group, the differences were statistically significant(P<0.05). The total incidence of postoperative complications in the combined treatment group was significantly lower than that in the single treatment group, and the difference was statistically significant(P<0.05). Conclusion Endoscopic tympanic membrane catheterization combined with adenoidectomy is more valuable than endoscopic tympanic membrane catheterization alone in the treatment of secretory otitis media in children with ineffective drug treatment, which is worthy of clinical promotion and application.
引文
[1]李鹏.耳内镜下鼓膜置管术治疗儿童分泌性中耳炎的疗效研究[J].中国实用医药,2015,10(3):59-60.
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[6]刘丹,吴曙辉,万浪,等.腺样体切除联合耳内镜下鼓膜置管或鼓膜穿刺治疗儿童分泌性中耳炎的疗效比较[J].中国微创外科杂志,2016,16(1):61-63.
[7]敬云龙,李赟,黄敏,等.腺样体切除术联合耳内镜下鼓膜置管治疗儿童分泌性中耳炎的效果分析[J].临床医学工程,2016,23(2):195-196.
[8] YOO MH,CHO YS,CHOI J,et al.Microbiological results from middle ear effusion in pediatric patients receiving ventilation tube insertion:multicenter registry study on the effectiveness of ventilation tube insertion in pediatric patients with chronic otitis media with effusion:part I[J].Clin Exp Otorhinolaryngol,2018,11(3):181-185.
[9] LIN DL,WU CS,TANG CH,et al.The safety and risk factors of revision adenoidectomy in children and adolescents:A nationwide retrospec tive population-based cohort study[J].Auris Nasus Larynx,2018,45(6):1191-1198.
[10]郭静,杨柏球,游舟,等.耳内镜下鼓膜置管术治疗儿童分泌性中耳炎的疗效及安全性效果评估[J].当代医学,2017,23(18):92-93.
[2]张亚梅.儿童分泌性中耳炎的诊断和治疗[J].中华耳鼻咽喉头颈外科杂志,2008,43(12):962-965.
[3]刘英冰.耳内镜下鼓膜置管联合腺样体切除术治疗儿童分泌性中耳炎的疗效观察[J].中国医药指南,2017,15(2):69.
[4]冯波,何勇.耳内镜下鼓膜置管术治疗儿童分泌性中耳炎76例临床疗效观察[J].中国现代医生,2014,52(5):23-25.
[5]陈春光.耳内镜鼓膜置管术治疗中耳炎的方法及疗效观察[J].当代医学,2012,18(22):83-84.
[6]刘丹,吴曙辉,万浪,等.腺样体切除联合耳内镜下鼓膜置管或鼓膜穿刺治疗儿童分泌性中耳炎的疗效比较[J].中国微创外科杂志,2016,16(1):61-63.
[7]敬云龙,李赟,黄敏,等.腺样体切除术联合耳内镜下鼓膜置管治疗儿童分泌性中耳炎的效果分析[J].临床医学工程,2016,23(2):195-196.
[8] YOO MH,CHO YS,CHOI J,et al.Microbiological results from middle ear effusion in pediatric patients receiving ventilation tube insertion:multicenter registry study on the effectiveness of ventilation tube insertion in pediatric patients with chronic otitis media with effusion:part I[J].Clin Exp Otorhinolaryngol,2018,11(3):181-185.
[9] LIN DL,WU CS,TANG CH,et al.The safety and risk factors of revision adenoidectomy in children and adolescents:A nationwide retrospec tive population-based cohort study[J].Auris Nasus Larynx,2018,45(6):1191-1198.
[10]郭静,杨柏球,游舟,等.耳内镜下鼓膜置管术治疗儿童分泌性中耳炎的疗效及安全性效果评估[J].当代医学,2017,23(18):92-93.