鼓膜置管治疗难治性分泌性中耳炎鼓膜穿孔危险因素分析

发布时间：2018-06-11 19:27

本文选题：分泌性中耳炎 + 难治性　；参考：《听力学及言语疾病杂志》2014年01期

【摘要】：目的探讨鼓膜通气管治疗难治性分泌性中耳炎后,患侧鼓膜永久性穿孔的危险因素。方法回顾性分析1998年6月~2013年3月收治的病程超过2年的121例(210耳)难治性分泌性中耳炎患者的临床资料,其中穿孔组58例(105耳),对照组(未穿孔组)63例(105耳)。所有患者均使用Goode—T型或Shepard哑铃型通气管行鼓膜置管治疗,分析可能影响患侧鼓膜永久性穿孔的因素,包括性别、年龄、病程、通气管类型、置管史、置管次数、鼓膜表象、置管位置、中耳腔积液性质、是否行腺样体切除术及拔管时间等。结果单因素分析显示,穿孔组Goode—T型通气管、有置管史、置管次数(3次以上)、中耳腔粘液性积液分别占58.4%、57.3%、66.7%和57.9%,且均高于对照组(均为P0.01)。Logistic回归分析提示无论采用何种通气管,置管次数增多则患侧鼓膜永久性穿孔的风险增加,采用Goode—T型管较Shepard哑铃型管鼓膜发生穿孔的危险性增加1.637倍(OR=1.637,P0.01)。结论难治性分泌性中耳炎患者鼓膜置管术后,使用Goode—T型通气管、有置管史、置管次数(3次以上)和中耳腔积液为黏液性四因素为鼓膜永久性穿孔的危险因素。
[Abstract]:Objective to investigate the risk factors of permanent perforation of tympanic membrane in patients with refractory secretory otitis media treated by tympanic membrane ventilation tube. Methods the clinical data of 121 patients with refractory secretory otitis media admitted from June 1998 to March 2013 were retrospectively analyzed, including 58 cases of perforation group (58 cases) and a control group (63 cases of unperforated group). All the patients were treated with Goode-T or Shepard dumbbell ventilation tube. The factors that might affect the permanent perforation of the affected tympanic membrane were analyzed, including sex, age, course of disease, type of ventilation tube, history of tube insertion, times of insertion, appearance of tympanic membrane. Tube placement, middle ear effusion, adenoidectomy and extubation time. Results univariate analysis showed that the Goode-T type ventilation tube in perforated group had a history of catheterization, the number of catheterization was more than 3 times, the mucous fluid in middle ear cavity accounted for 58.7% and 57.9%, respectively, and it was higher than that in control group (all P0.01. logistic regression analysis showed that no matter what kind of tube was used. The risk of permanent perforation of the tympanic membrane was increased with the increase of the number of tube insertion. The risk of perforation of the tympanic membrane with Goode-T tube was 1.637 times higher than that with Shepard dumbbell-shaped tube, and the risk of perforation was 1.637 times higher than that of Shepard dumbbell tube. Conclusion after tympanic membrane catheterization in patients with refractory secretory otitis media, the use of Goode-T ventilation tube, with a history of tube indwelling and more than 3 times of tube insertion, and middle ear cavity effusion are risk factors for permanent perforation of tympanic membrane.
【作者单位】：广州军区广州总医院耳鼻咽喉科;南方医科大学珠江医院耳鼻咽喉头颈外科;
【分类号】：R764

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