腺样体消融联合鼓膜打孔术治疗儿童腺样体肥大合并分泌性中耳炎55例

doi:10.6040/j.issn.1673-3770.1.2020.097

摘要/Abstract

摘要： 目的探讨同时运用低温等离子技术开展腺样体消融术联合耳内镜下鼓膜打孔术的前提下,治疗腺样体肥大合并分泌性中耳炎患儿的临床疗效。方法将确诊为腺样体肥大合并分泌性中耳炎的患儿111例(183耳)随机分为实验组55 例(89耳)和对照组56 例(94耳),两组均接受鼻内窥镜下腺样体低温等离子消融术,对照组实施鼓膜切开术,实验组给予耳内镜下低温等离子鼓膜打孔。术后观察两组临床疗效、感染发生率,随访6个月统计两组复发率。结果浆液型分泌性中耳炎在实验组与对照组中的有效率、感染率、复发率方面无统计学意义(P>0.05)。黏液型分泌性中耳炎在实验组与对照组的感染率方面差异无统计学意义(P=0.191),而在有效率方面实验组高于对照组,差异有统计学意义(P=0.006),术后复发率则相反,差异有统计学意义(P=0.012)。结论采用腺样体低温等离子消融联合耳内镜下低温等离子鼓膜打孔治疗分泌性中耳炎的疗效显著,特别是在儿童黏液型分泌性中耳炎,且在减少术后复发风险方面具有一定价值。

关键词: 分泌性中耳炎, 腺样体肥大, 腺样体消融, 低温等离子, 鼓膜打孔, 儿童

Abstract: Objective To explore the clinical efficacy of low temperature plasma adenoid ablation combined with low-temperature plasma tympanostomy for the treatment of secretory otitis media in children. Methods A total of 111 children(183 ears)with adenoid hypertrophy and secretory otitis media were randomly divided into an experimental group(55 cases, 89 ears)and a control group(56 cases, 94 ears). Both groups underwent low temperature plasma endoscopic adenoid ablation. Additionally, the control group underwent tympanoplasty while the experimental group underwent low-temperature plasma tympanoplasty under otoendoscope. The effectiveness and infection rates in the two groups were recorded after surgery, and the recurrence rate in the two groups was determined after six months of follow-up. Results There was no significant difference in the effective rates, infection rates and recurrence rates of serous secretory otitis media between the experimental group and the control group. The infection rate of mucinous secretory otitis media was not significantly different between the experimental group and the control group(P=0.191), but the effective rate of the experimental group was higher than that of the control group(P=0.006), and the postoperative recurrence rate was opposite, the difference was statistically significant(P=0.012). Conclusion Low temperature plasma adenoid ablation combined with low-temperature plasma tympanostomy has good therapeutic effect on secretory otitis media in children and may reduce the risk of postoperative recurrence.

Key words: Secretory otitis media, Adenoid hypertrophy, Adenoid ablation, Low temperature plasma, Tympanic membrane perforation, Children

中图分类号:

R764.21

吴华,孙永明,郑建华,蔡雪花. 腺样体消融联合鼓膜打孔术治疗儿童腺样体肥大合并分泌性中耳炎55例[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 71-75.

WU Hua, SUN Yongming, ZHENG Jianhua, CAI Xuehua. Application of endoscopic adenoids cryoablation combined with low-temperature plasma tympanostomy in the treatment of 55 children with adenoid hypertrophy and secretory otitis media[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 71-75.

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