耳内窥镜下鼓膜切开置管治疗慢性分泌性中耳炎的临床分析(1)
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【摘要】目的：探讨耳内窥镜下鼓膜切开置管治疗慢性分泌性中耳炎的疗效。方法：以我院42例慢性分泌性中耳炎患者为治疗组，以同期收治的40例慢性分泌性中耳炎患者为对照组。在常规抗炎治疗基础上，对照组给予咽鼓管导管吹张术，治疗组给予耳内窥镜下鼓膜切开置管术，比较2组疗效。结果：2组好转率差异没有统计学意义，P>0.05；治疗组治愈率高于对照组；无效率低于对照组，经检验，差异具有统计学意义，P<0.05。结论：耳内窥镜下鼓膜切开置管术治疗慢性分泌性中耳炎，操做简便，疗效显著。
【关键词】内窥镜；慢性分泌性中耳炎；鼓膜切开置管
Clinical analysis of the effect of endoscopic myringotomy and grommet insertion for chronic otitis media with effusion
Huang Hong-jie
【Abstract】Objective:To investigate the effect of endoscopic myringotomy and grommet insertion for chronic otitis media with effusion.Methods:42 cases of chronic otitis media with effusion in our hospital were as the therapeutic group.40 cases were as the control group at the same preriod.2 groups were all gave the routine treanment of anti-inflammatory.The control was gave the blowing and expansion of eustachian through catheter.The therapeutic group was gave myringotomy and grommet insertion.hnique.To compare the effect of 2 groups. Results:The rate of improvement of 2 groups was not statistically significant,P>0.05.The curative rate of the therapeutic group was higher than the controlgroup.The noneffective rate of the therapeutic group was lower than the controlgroup.The difference was all statistically significant, P<0.05.Conclusion: endoscopic myringotomy and grommet insertion was easy to operate and good effect for chronic otitis media with effusion.
【Key words】 endoscopy; chronic otitis media with effusion; chronic secretory otitis media; myringotomy and grommet insertion
【中图分类号】R85.3 【文献标识码】B【文章编号】1005-0515(2011)08-0219-02
慢性分泌性中耳炎是指中耳积液、听力下降为主要特征的中耳疾病，表现为中耳乳膜、骨膜或深达骨质的化脓性炎症，其分泌物粘稠，非手术治疗效果较差，可以引起严重的颅内外并发症[1]。治疗上多以手术显微镜下行鼓膜切开并放置中耳通气管，但仍有创伤大的缺点。随着内窥镜的广泛应用，在耳内窥镜下行鼓膜切开中耳腔置管可在直视下进行，创伤小，疗效好。对我院42例慢性分泌性中耳炎患者给予耳内窥镜下鼓膜切开置管术，疗效满意，分析报告如下。
1 临床资料和方法
1.1一般资料：以我院2006年1月~2008年12月耳鼻喉科收治的42例慢性分泌性中耳炎患者为治疗组，男25例，女17例，年龄15~64，平均39.34±12.35月；病程6~25月，平均16.13±3.25月。以同期收治的40例患者为对照组，其中男26例，女14例，年龄13~66，平均37.89±13.28月；病程7~27月，平均18.62±5.32月。所有患者主要表现为听力下降、耳阻塞感和耳鸣等；检查有鼓膜内陷、光锥消失、鼓膜活动减弱或消失等；中耳有明显的积液平，电测听示传导性或混合性聋，气骨导差<30dBHL，鼓室导抗图为“B”型曲线，鼓室负压；常规药物及物理治疗后，症状没有好转[2]。2组在男女比例、年龄及病程方面差异没有统计学意义，p>0.05，具有可比性。
1.2治疗方法：(1)对照组：给予咽鼓管导管吹张术；口服头孢氨苄胶囊。(2)治疗组：给予耳内窥镜下鼓膜切开置管术。具体如下，患者取坐位，常规消毒外耳道，经外耳道插入零度耳内镜，在显示屏直视下行操作。首先仔细观察鼓膜及中耳积液情况，鼓膜用麻醉剂棉片行表面麻醉 ......
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