鼓膜置管与穿刺对慢性分泌性中耳炎的疗效*

熊子云

【摘要】 目的：比较耳内镜下鼓膜置管、鼓膜穿刺治疗慢性分泌性中耳炎的临床应用价值。方法：用随机数字表法在笔者所在医院2017年1月-2018年3月收治的慢性分泌性中耳炎患者中纳入75例为对象，单盲法分组为对照组32例和观察组43例。采用耳内镜下鼓膜穿刺术治疗对照组患者，采用耳内镜下鼓膜置管术治疗观察组患者，比较两组患者临床治疗效果及并发症发生率。结果：观察组患者治疗总有效率为95.35%，高于对照组的78.13%，观察组患者并发症发生率为4.65%，低于对照组的34.38%，差异均有统计学意义（P<0.05）。结论：慢性分泌性中耳炎患者临床治疗时，选择耳内镜下鼓膜置管术治疗的效果优于鼓膜穿刺术，且患者术后并发症少。

【关键词】 慢性中耳炎; 分泌性; 耳内镜; 鼓膜置管术; 鼓膜穿刺术; 临床价值

doi：10.14033/j.cnki.cfmr.2019.14.019 文献标识码 B 文章编号 1674-6805（2019）14-00-02

Therapeutic Effect of Tympanic Membrane Catheterization and Puncture on Chronic Secretory Otitis Media/XIONG Ziyun.//Chinese and Foreign Medical Research，2019，17（14）：-46

【Abstract】 Objective：To compare the clinical value of tympanic membrane catheterization and tympanic membrane puncture under endotoscpe in the treatment of chronic secretory otitis media.Method：A total of 75 patients with chronic secretory otitis media admitted to our hospital from January 2017 to March 2018 were divided into control group（32 cases） and observation group（43 cases）.The patients in the control group were treated with endotoscpe tympanocentesis and the patients in the observation group were treated with endotoscpe tympanocentesis.The clinical effects and complications of the two groups were compared.

Result：The effective rate of treatment in the observation group was 95.35%，which was higher than 78.13% in the control group，the incidence of complications in the observation group was 4.65%，which was lower than 34.38% in the control group，the differences were statistically significant（P<0.05）.Conclusion：In the clinical treatment of chronic secretory otitis media，the effect of tympanic membrane catheterization under endotoscpe is better than that of tympanic membrane puncture，and the complications after operation are less.

【Key words】 Chronic otitis media; Secretory; Endotoscpe; Tympanoplasty; Tympanocentesis; Clinical value

First-authors address：Xiantao First Peoples Hospital Affiliated to Changjiang University，Xiantao 433000，China

分泌性中耳炎即滲出性中耳炎，通常均见患者的咽鼓管呈机械性、功能性功能障碍的情况[1]。目前，临床上用来治疗分泌性中耳炎的方法与手段诸多，但是对于慢性分泌性中耳炎则有着参差不齐的效果，为了进一步提高慢性分泌性中耳炎的治疗效果，本次研究则在笔者所在医院2017年1月-2018年3月内收治的慢性分泌性中耳炎患者中，纳入75例患者为对象，依据单盲法分组法将其分为对照组和观察组，两组患者分别接受不同的手段治疗，旨在对慢性分泌性中耳炎患者接受不同手段（耳内镜下鼓膜置管、鼓膜穿刺）治疗的临床效果进行探讨，现将获得的各项数据作下述报道。

1 资料与方法

1.1 一般资料

用随机数字表法在笔者所在医院2017年1月-2018年3月收治的慢性分泌性中耳炎患者中纳入75例为对象，患者病情均符合文献[2]中的诊断标准描述，病情经影像学检查证实，见患者听力降低、耳阻塞感强烈，部分患者合并耳聋、耳痛的情况，排除先天性听力障碍、精神障碍、体循环和血液疾病及依从性/配合度不高的患者。单盲法分组为对照组32例和观察组43例。对照组患者中男19例，女13例，年龄12～65岁，平均（30.85±5.29）岁，病程3～10个月，平均（6.73±1.85）个月，单耳发病21例，双耳发病11例;观察组患者中男23例，女