低温等离子手术治疗分泌性中耳炎的临床研究

发布时间：2019-03-06 12:41

【摘要】：目的探讨内镜下低温等离子手术(耳内镜下鼓膜打孔术+鼻内镜下腺样体和/或下鼻甲消融术/功能性鼻内镜术)治疗"分泌性中耳炎"的疗效,并发症,优势及复发率。资料与方法分析研究156例病史超过3个月,由腺样体肥大和慢性鼻-鼻窦炎引起的分泌性中耳炎患者,所有病例针对病因先行鼻内镜下等离子腺样体和/或下鼻甲消融术/功能性鼻内镜术,研究组(78例)患者同期行等离子鼓膜打孔术,对照组(78例)行鼓膜置管术。结果所有患者随访6个月,以术后1周、1月、3月及6月时的检查结果作对比,研究组78例患者鼓膜打孔处约1-3月愈合,两组治愈好转率经比较,P值均0.001,差异有统计学意义。并发症以中耳感染、流脓为主要参考指标,对照组的并发症在不同时段均明显高于研究组,经卡方检验,术后1周P值为0.043,其余均P0.001,两组患者在并发症的发生率上有显著差别,差异有统计学意义。结论内镜下低温等离子手术(腺样体和/或下鼻甲消融术/功能性鼻内镜术+鼓膜打孔术)治疗分泌性中耳炎具有疗效好,创伤小,并发症少,复发率低等优势。
[Abstract]:Objective to investigate the efficacy, complications, advantages and recurrence rate of endoscopic hypothermic plasma surgery (endoscopic tympanoplasty and / or inferior turbinate ablation / functional endoscopy) in the treatment of secretory otitis media. Materials and methods 156 patients with secretory otitis media caused by adenoid hypertrophy and chronic rhinosinusitis were analyzed. All patients were treated with plasma adenoid and / or inferior turbinate ablation / functional rhinoscopy under nasal endoscopy. Plasma tympanoplasty was performed in 78 patients in the study group and tympanoplasty was performed in 78 patients in the control group at the same time. The patients in the study group (n = 78) were treated with plasma tympanoplasty and the control group (n = 78). Results all the patients were followed up for 6 months. Compared with the results at 1 week, 1 month, 3 months and 6 months after operation, 78 patients in the study group healed around 1-3 months in the tympanic perforations. The recovery rates of the two groups were compared, P = 0.001, P < 0.01, respectively. The difference is statistically significant. The complications in the control group were significantly higher than those in the study group at different time points. After chi-square test, the P value was 0.043 at one week after operation, and the rest were all P0.001, and the other complications were significantly higher in the control group than in the study group at different time points. There was a significant difference in the incidence of complications between the two groups, the difference was statistically significant. Conclusion Endoscopic hypothermic plasma surgery (adenoid and / or inferior turbinate ablation / functional endoscope tympanoplasty) has the advantages of good curative effect, less trauma, less complications and lower recurrence rate in the treatment of secretory otitis media.
【作者单位】：甘肃省天水市第一人民医院耳鼻喉头颈外科;
【基金】：2013年度甘肃省天水市科技支撑计划研究项目
【分类号】：R764.9

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