鼓膜置管术后通气管阻塞的因素分析以及应对策略

发布时间：2018-03-23 12:59

本文选题：中耳炎　切入点：伴渗出液　出处：《临床耳鼻咽喉头颈外科杂志》2017年09期

【摘要】：目的:研究鼓膜置管术后通气管阻塞的危险因素以及相应的应对措施。方法:回顾性分析2010-02-2015-02期间行鼓膜置管的145例患者(198耳),术后未滴药;以及2015-03-2016-02期间行鼓膜置管的59例患者(80耳),该组术后均给予氧氟沙星滴耳液。分别在术后1、3、6、12个月随访,检查通气管的位置,是否有阻塞发生。如发现干痂、耵聍或血痂阻塞,应用4%碳酸氢钠滴耳液滴耳后清理,根据清理结果和是否再次出现积液情况,采取随访或再次置入新的通气管。对于有脓性分泌物的患者,给予3%双氧水和氧氟沙星滴耳液,使通气管再通。结果:在未滴药的145例(198耳)中,共有16例患者出现通气管阻塞,其中管腔内干痂阻塞8例,血痂阻塞或覆盖通气管3例,耵聍阻塞3例,脓性分泌物2例。滴药的59例患者中,共有7例出现通气管阻塞,其中管腔内干痂阻塞1例,血痂阻塞或覆盖通气管1例,耵聍阻塞4例,脓性分泌物1例。结论:鼓膜置管术后通气管阻塞较为常见,术中、术后可进行预防和处理,术后短期抗生素滴耳可以有效预防通气管阻塞和术后感染的发生。
[Abstract]:Objective: to study the risk factors of ventilation tube obstruction after tympanic membrane catheterization and the corresponding countermeasures. Methods: 145 patients with tympanic membrane tube were treated with tympanic membrane tube during 2010-02-2015-02. And 59 patients who underwent tympanic membrane tube insertion during 2015-03-2016-02 were treated with ofloxacin ear drops after operation. The patients were followed up for 6 and 12 months, respectively, to check the location of the ventilation tube and whether there was any obstruction. If dry scab, cerumen or blood scab were found, After using 4% sodium bicarbonate ear drops to clean the ears, according to the results of cleaning and whether or not there is a recurrence of hydrops, a follow-up or re-placement of a new ventilation tube. For patients with purulent secretions, 3% hydrogen peroxide and ofloxacin ear drops are given. Results: there were 16 patients with obstruction of ventilation tube, including 8 cases of dry callus obstruction in the lumen, 3 cases of blood callus obstruction or covered ventilation tube, 3 cases of cerumen obstruction, and 3 cases of cerumen obstruction. 2 cases of purulent secretions, 7 cases of obstruction of ventilation tube, including 1 case of obstruction of dry callus in the lumen, 1 case of obstruction or overlay of blood callus, 4 cases of cerumen obstruction, 2 cases of purulent secretions, 7 cases of obstruction of ventilation tube, 4 cases of cerumen obstruction. Conclusion: obstruction of ventilation tube is more common after tympanic membrane tube insertion. During operation and after operation, prevention and treatment can be carried out, and short-term antibiotic dropping can effectively prevent obstruction of ventilation tube and postoperative infection.
【作者单位】：复旦大学附属眼耳鼻喉科医院耳鼻咽喉科国家卫计委听觉医学重点实验室上海市听觉医学临床中心;
【基金】：国家自然科学基金(No:NSFC81300824) 上海市浦江人才资助项目(No:15PJ1401000)
【分类号】：R764.9

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