山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (5): 61-65.doi: 10.6040/j.issn.1673-3770.0.2017.448

• ·论著· • 上一篇    下一篇

鼓膜微管置入术治疗中耳不张76例临床分析

孟立新,李健,韦善文   

  1. Z2014347)第一作者:孟立新。 E-mail:sangwang21831@163.comDOI:10.6040/j.issn.1673-3770.0.2017.448鼓膜微管置入术治疗中耳不张76例临床分析孟立新, 李健, 韦善文(广西河池市人民医院耳鼻咽喉头颈外科, 广西 河池 547000
  • 收稿日期:2017-10-26 出版日期:2018-09-20 发布日期:2018-09-20
  • 基金资助:
    广西壮族自治区卫生厅科研课题(Z2014347)

Insertion of microtubules in tympanic membrane for the treatment of middle ear atelectasis

MENG Lixin, LI Jian, WEI Shanwen   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Guangxi Hechi Peoples Hospital, Hechi 547000, Guangxi, China
  • Received:2017-10-26 Online:2018-09-20 Published:2018-09-20

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摘要： 目的 分析鼓膜微管置入术治疗中耳不张的临床疗效。 方法 选取76例中耳不张患者,根据Dornhffer的综合分析法分级分为两组各38例,A组为Ⅰ、Ⅱ级中耳不张患者,B组为Ⅲ、Ⅳ级中耳不张患者,对比两组术前、术后1周、1个月、6个月纯音听阈测听及声导抗结果,比较两组的治疗效果,观察并发症发生情况和复发情况。 结果 两组在术前和经过鼓膜微管置入术治疗后1周、1个月、6个月的纯音听阈测听结果变化趋势存在统计学差异(P均<0.05)。两组从治疗前到经手术治疗后1周、1个月、6个月的声导抗检查变化趋势均存在统计学差异(P均<0.05)。A组总有效36例(94.74%),B组总有效30例(78.95%),两组总有效率比较,差异有统计学意义(P<0.01)。A组并发症发生0例、复发0例,B组并发症发生2例(5.26%)、复发3例(7.89%),两组并发症发生率及复发率比较,差异有统计学意义(P均<0.05)。 结论 鼓膜微管置入术对Ⅰ、Ⅱ级中耳不张患者临床效果较好,能有效降低并发症发生率及复发率。

关键词: 中耳不张, 鼓膜微管置入术, 手术方法, 临床疗效

Abstract: Objective To analyze the clinical efficacy of tympanic membrane microtubule placement in the treatment of middle ear edema. Methods Seventy-six patients with middle ear atelectasis were divided into two groups according to Dornhoffers staging criteria. Group A was comprised of 38 patients with middle ear atelectasis classified as grade Ⅰ or Ⅱ, and group B was comprised of patients with grades Ⅲ or Ⅳ. The results of pure tone audiometry and acoustic impedance measurements were compared for the two groups before surgery and 1 week, 1 month, and 6 months afterward, to assess the effects of treatment and observe the occurrence and recurrence of complications. Results There were statistically significant differences between the two groups in pure tone audiometry before tympanic microtubule implantation and at 1 week, 1 month, and 6 months afterward(P<0.05). There were also statistically significant differences in acoustic impedance before treatment and at 1 week, 1 month and 6 months afterward(P<0.05). In Group A, 36 cases(94.74%)showed fully effectiveness, compared to 30 cases(78.95%)in group B. The difference in efficacy was significant(P<0.01). In group A there were no cases of complications and no cases of recurrence, while in group B there were 2 cases(5.26%)with complications and 3 cases(7.89%)with recurrence. The incidence of complications and recurrence rate differed significantly in the two groups(P<0.05). Conclusion Tympanic microtubule implantation has good clinical effects in patients with grade Ⅰ or Ⅱ middle ear atelectasis, and can effectively reduce the incidence of complications and recurrence rate.

Key words: Tympanic membrane microtubule implantation, Surgical method, Clinical effect, Middle ear atelectasis

中图分类号: 

  • R764.9
[1] Akbulut S, Demir MG, Salepci BM, et al. Efficacy of continuous positive airway pressure on middle ear atelectasis: A double-blind placebo-controlled clinical trial[J]. Laryngoscope, 2016, 126(7):1649-1655.
[2] JBorgstein J, Gerritsma TV, Wieringa MH, et al. The Erasmus atelectasis classification: proposal of a new classification for atelectasis of the middle ear in children[J]. Laryngoscope, 2007, 117(7):1255-1259.
[3] 王治强,张庆泉. 中耳不张对听力的影响及早期治疗效果观察[J]. 中华耳科学杂志,2015,13(4):698-699. WANG Zhiqiang, ZHANG Qingquan. Impact of middie ear atelectasis on hearing and effects of early treatment[J]. Chin J Otol, 2015, 13(4):698-699.
[4] 王治强,都基亮,马秀芳,等. 鼓膜微型管置入术治疗中耳不张32例[J]. 山东大学耳鼻喉眼学报,2012,26(1):63-65. WANG Zhiqiang, DU Jiliang, MA Xiufang, et al. Placement of a tympanostomy microtube to treat middle ear atelectasis in 32 cases[J]. J Otolaryngol Ophthalmol Shandong Univ, 2012, 26(1):63-65.
[5] 宋红毛,杜晓东. 微管置管治疗分泌性中耳炎疗效分析[J]. 江苏医药,2012,38(9):1083-1084. SONG Hongmao, DU Xiaodong. Analysis of efficacy of microtube insertion for treating secretory otitis media[J]. Jiangsu Med J, 2012, 38(9):1083-1084.
[6] Dornhoffer JL. Surgical management of the atelectatic ear[J]. Am J Otol, 2000, 21(3):315-321.
[7] Danner CJ. Middle ear atelectasis: what causes it and how is it corrected[J]. Otolaryngol Clin North Am, 2006, 39(6):1211-1219.
[8] Fink N, Ar A, Sadé J, et al. Mathematical analysis of atelectasis formation in middle ears with sealed ventilation tubes[J]. Acta Physiol Scand, 2003, 177(4):455-458.
[9] 杨乐,龚平桂,郑明奋,等. 咽鼓管及咽鼓管功能障碍相关疾病的发生与治疗[J]. 临床耳鼻咽喉头颈外科杂志,2016,30(12):1001-1005. YANG Le, GONG Pinggui, ZHENG Mingfen, et al. Eustachian tube and its dysfunction related diseases occurence and treatments[J]. J Clin Otorhinolaryngol Head Neck Surg, 2016, 30(12):1001-1005.
[10] Noij KS, Noij DP, Borgstein J. Healing of the tympanic membrane after surgical intervention for atelectasis of the middle ear in sixty-two adults[J]. Clin Otolaryngol, 2016, 42(2):450-454.
[11] 李健,韦善文,孟立新. 微管置管治疗中耳不张的疗效分析[J]. 广西医科大学学报,2016,33(2):332-333.
[12] 张静,卢伟,孙淑萍,等. 鼓膜置管术治疗鼓膜膨胀不全的疗效分析[J]. 听力学及言语疾病杂志,2014,22(2):142-144. ZHANG Jing, LU Wei, SUN Shuping, et al. Myringotomy with grommet insertion for treatment of tympanic membrane[J]. J Audiol Speech Pathol, 2014, 22(2):142-144.
[13] 蔡红武,唐安洲,陈平,等. 长期吸鼻致中耳不张[J]. 中国耳鼻咽喉头颈外科,2009,16(11):662.
[14] 陈仁辉,吴先光,危小琴,等. Tos改良联合进路鼓室成型术的初步经验[J].广东医学院学报,2013,31(5):553-555.
[15] Borgstein J, Gerritsma T, Bruce I, et al. Atelectasis of the middle ear in pediatric patients: safety of surgical intervention[J]. Int J Pediatr Otorhinolaryngol, 2009, 73(2):257-261.
[16] Borgstein J, Gerritsma TV, Wieringa MH, et al. The Erasmus atelectasis classification: proposal of a new classification for atelectasis of the middle ear in children[J]. Laryngoscope, 2007, 117(7):1255-1259.
[17] 梁茂金,张志钢,许耀东,等. 咽鼓管球囊扩张术治疗慢性分泌性中耳炎的疗效分析[J]. 中国医学文摘(耳鼻咽喉科学),2015,32(6):315-318, 323. LIANG Maojin, ZHANG Zhigang, XU Yaodong, et al. Effectiveness of baloon eustachian tuboplasty on hronic otitis media with effusion[J]. Chin Med Digest: Otolaryngol, 2015, 32(6):315-318, 323.
[18] 唐志辉,陈仁辉. 成人分泌性中耳炎[J]. 临床耳鼻咽喉头颈外科杂志,2014,28(13):925-929. TANG Zhihui, CHEN Boren. Otitis media with effusion in the adult[J]. J Clin Otorhinolaryngol Head Neck Surg, 2014, 28(13):925-929.
[19] 吴红丽. 聚维酮碘治疗化脓性中耳炎合并真菌感染的临床特征及其预后影响因素分析[J].中国临床研究,2014,27(7):860-862.
[20] Seibert JW, Danner CJ. Eustachian tube function and the middleear[J]. Otolaryngol Clin North Am, 2006, 39(6):1221-1235.
[21] Sedlmaier B, Pomorzev A, Haisch A, et al. The improvement of middle ear ventilation by laser ablation of the epipharyngeal eustachian tube: a prospective study[J]. Lasers Med Sci, 2009, 24(5):793-800.
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