改良Politzer仪治疗儿童慢性分泌性中耳炎的疗效评估

发布时间：2018-11-09 08:20

【摘要】：目的 :评估改良Politzer仪治疗儿童慢性分泌性中耳炎(otitis media with effusion,OME)的临床疗效。方法 :将确诊为双耳慢性OME伴听力损失的43例患儿随机分为A、B组。A组22例使用改良Politzer仪行咽鼓管吹张治疗;B组21例行观察随访。4周后,两组交叉。两组患儿在入组、4周及8周接受耳内镜检查、声导抗及纯音听阈测试。结果:治疗4周后A组有20耳(45%)中耳压力和纯音听阈恢复正常,14耳(32%)有好转,B组中6耳(14%)恢复正常,4耳(10%)好转,两组疗效差异有统计学意义(P0.005)。两组交叉后,B组经过4周吹张治疗后有17耳(40%)恢复正常,13耳(31%)有好转;A组有24耳(55%)恢复正常,14耳(32%)有好转,两组疗效差异有统计学意义(P0.05)。两组共有8例(19%)接受鼓膜置管术。结论:利用改良Politzer仪进行咽鼓管吹张能有效治疗患儿慢性OME,越早吹张治疗效果越好,从而降低手术机率。
[Abstract]:Objective: to evaluate the clinical effect of modified Politzer instrument on chronic secretory otitis media (otitis media with effusion,OME) in children. Methods: 43 children with chronic binaural OME with hearing loss were randomly divided into group A (n = 22) treated with modified Politzer apparatus and group B (n = 21) followed up for 4 weeks. The two groups received endoscopy, acoustic impedance and pure tone audiometry at 4 weeks and 8 weeks. Results: after 4 weeks of treatment, 20 ears (45%) in group A had normal middle ear pressure and pure tone hearing threshold, 14 ears (32%) had improved, 6 ears (14%) in group B had recovered to normal, 4 ears (10%) had improved. The difference between the two groups was statistically significant (P 0.005). In group B, 17 ears (40%) returned to normal and 13 ears (31%) improved after 4 weeks of treatment. In group A, 24 ears (55%) returned to normal and 14 ears (32%) improved. The difference between the two groups was statistically significant (P0.05). A total of 8 cases (19%) received tympanic membrane catheterization in both groups. Conclusion: the improved Politzer instrument can effectively treat children with chronic OME, as early as possible, thus reducing the probability of operation.
【作者单位】：南京医科大学第一附属医院耳鼻咽喉科世界卫生组织预防聋和听力减退合作中心江苏省耳科疾病与听力障碍诊治中心;
【基金】：江苏高校优势学科建设工程(JX10231801)
【分类号】：R764.21

【相似文献】