儿童鼓膜通气管留置时间与并发症关系

Retaining time of tympanic ventilation tube and aural complications

目的:研究儿童鼓膜通气管留置时间与并发症的关系。方法:364例(714耳)分泌性中耳炎(OME)患儿鼓膜置管后1～36个月取管,总结不同时间段取管并发症出现比例,并进行统计分析。结果:通气管留置1～6个月29例(55耳),其中脱管1例(3.4%),堵管3例(10.3%),置管陷入鼓室0例,肉芽增生0例,胆脂瘤0例,耳漏2例(6.9%),鼓膜穿孔0例;6～12个月96例(190耳),其中脱管7例(7.3%),堵管15例(15.6%),置管陷入鼓室1例(1.0%),肉芽增生0例,胆脂瘤0例,耳漏5例(5.2%),鼓膜穿孔0例;留置12～24个月156例(308耳),其中脱管14例(9.0%),堵管20例(12.8%),置管陷入鼓室2例(1.3%),肉芽增生3例(1.9%),胆脂瘤1例(0.6%),耳漏4例(2.5%),鼓膜穿孔0例;留置24～36个月83例(161耳),其中脱管30例(36.1%),堵管44例(53.0%),置管陷入鼓室5例(6.0%),肉芽增生3例(3.6%),胆脂瘤2例(2.4%),耳漏2例(2.4%),鼓膜穿孔2例(2.4%)。全部病例未发现鼓室硬化者。结论:2年以内鼓膜通气管留置时间与并发症关系不大;2年以上脱管和堵管发生率显著增高,其他并发症发生率无显著增高。

Objective：To study the relationship of retaining time of tympanic ventilation tube and aural complications. Method：Three-hundred-five patients（659 ears）with otitis media with effusion（OME）received tympanostomy tube insertion. The tube were removed 6-36 months after tube insertion. Then aural complications were recorded in different tube retaining time, followed with a statistic analysis. Result： Fifty-five tubes of 29 patients were removed at 1-6 months after tube insertion, with spontaneous extrusion 3.4%, blocked tube 10.3%, intrusion in- to the middle ear 0, granulation tissue 0, cholesteatoma 0, otorrhea 6.9%, perforation 0. One hundred and ninty tubes of 96 patients were removed at 6 - 12 months after tube insertion , with spontaneous extrusion 7. 3%, blocked tube 15.6%, intrusion into the middle ear 1%, granulation tissue 0, cholesteatoma 0, otorrhea 5. 2%, perforation 0. Three huandred and eight tubes of 156 patients Were removed at 12-24 months after tube insertion , with spontaneous extrusion 9% ,blocked tube 12.8% ,intrusion into the middle ear 1.3% ,granulation tissue 1. 9% ,cholesteatoma 0.6% ,otorrhea 2.5% ,perforation was 0. One hundred and sixty one tubes of 83 patients were removed at 24-36 months after tube insertion , with spontaneous extrusion 36.1%, blocked tube 53 %, intrusion into the middle ear 6%, granulation tissue 3.6%, cholesteatoma 2.4%, otorrhea 2.4%, perforation 2.4%. Conclusion：The occurence of complication didn＇t increase with time going by when the ventilation tube retained less than two years. However, when the ventilation tube retained more than two years, the occurence of spontaneous extrusion and blocked tube increased obviously.