鼓膜置管與穿刺對慢性分泌性中耳炎的療效*

熊子云

【摘要】 目的：比較耳內鏡下鼓膜置管、鼓膜穿刺治療慢性分泌性中耳炎的臨床應用價值。方法：用隨機數字表法在筆者所在醫院2017年1月-2018年3月收治的慢性分泌性中耳炎患者中納入75例為對象，單盲法分組為對照組32例和觀察組43例。采用耳內鏡下鼓膜穿刺術治療對照組患者，采用耳內鏡下鼓膜置管術治療觀察組患者，比較兩組患者臨床治療效果及并發癥發生率。結果：觀察組患者治療總有效率為95.35%，高于對照組的78.13%，觀察組患者并發癥發生率為4.65%，低于對照組的34.38%，差異均有統計學意義（P<0.05）。結論：慢性分泌性中耳炎患者臨床治療時，選擇耳內鏡下鼓膜置管術治療的效果優于鼓膜穿刺術，且患者術后并發癥少。

【關鍵詞】 慢性中耳炎; 分泌性; 耳內鏡; 鼓膜置管術; 鼓膜穿刺術; 臨床價值

doi：10.14033/j.cnki.cfmr.2019.14.019 文獻標識碼 B 文章編號 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，通常均見患者的咽鼓管呈機械性、功能性功能障礙的情況[1]。目前，臨床上用來治療分泌性中耳炎的方法與手段諸多，但是對于慢性分泌性中耳炎則有著參差不齊的效果，為了進一步提高慢性分泌性中耳炎的治療效果，本次研究則在筆者所在醫院2017年1月-2018年3月內收治的慢性分泌性中耳炎患者中，納入75例患者為對象，依據單盲法分組法將其分為對照組和觀察組，兩組患者分別接受不同的手段治療，旨在對慢性分泌性中耳炎患者接受不同手段（耳內鏡下鼓膜置管、鼓膜穿刺）治療的臨床效果進行探討，現將獲得的各項數據作下述報道。

1 資料與方法

1.1 一般資料

用隨機數字表法在筆者所在醫院2017年1月-2018年3月收治的慢性分泌性中耳炎患者中納入75例為對象，患者病情均符合文獻[2]中的診斷標準描述，病情經影像學檢查證實，見患者聽力降低、耳阻塞感強烈，部分患者合并耳聾、耳痛的情況，排除先天性聽力障礙、精神障礙、體循環和血液疾病及依從性/配合度不高的患者。單盲法分組為對照組32例和觀察組43例。對照組患者中男19例，女13例，年齡12～65歲，平均（30.85±5.29）歲，病程3～10個月，平均（6.73±1.85）個月，單耳發病21例，雙耳發病11例;觀察組患者中男23例，女