经鼻内镜腺样体切除治疗儿童分泌性中耳炎的临床价值

Clinical value of endoscopic adenoidectomy in the treatment of children with secretory otitis media

目的：探讨腺样体切除对儿童内分泌性中耳炎听力的影响。方法：选取我院2008年9月~2010年9月收治的180例内分泌性中耳炎患者,采用经鼻内镜腺样体切除术治疗的90例患者为治疗组,采用保守治疗的90例患者为对照组,回顾性分析其3个月的随访资料,比较两组患者的手术疗效、术后并发症以及治疗组各频率听阈变化情况。结果：治疗组患者显效61例,有效24例,总有效率为94.44%;对照组显效52例,有效22例,总有效率为82.22%,治疗组患者疗效明显优于对照组,两组比较,差异有统计学意义（P〈0.05）。治疗组患者并发症发生率（8.89%）明显低于对照组（36.67%）,两组比较,差异有统计学意义（P〈0.05）。治疗组患者治疗后各频率听阈均明显上升,治疗前后比较,差异有统计学意义（P〈0.05）。结论：鼻内镜下腺样体切除术治疗儿童分泌性中耳炎,疗效满意,并发症少,能显著提高患儿的生活质量,值得在临床推广应用。

Objective： To explore the impact hearing in children with secretory otitis media treating by endoscopic adenoidectomy.Methods： 180 secretory otitis media patients in our hospital were selected from September 2008 to September 2010,90 patients treated by endoscopic adenoidectomy were selected as treatment group,the other 90 patients treated by conservative treatment were selected as control group,and their follow-up data of 3 months were retrospectively analyzed.Operative efficacy and complications after operation and changes in hearing threshold at each frequency of the two groups were compared.Results： In the treatment group,61 cases were significantly effective,24 cases were effective,the total effective rate was 94.44%;In the control group 52 cases were significantly effective,22 cases were effective,the total effective rate was 82.22%,the treatment group was better than control group,and there were significant differences between them（P〈0.05）.Complications incidences of the treatment group（8.89%） were significantly lower than those of control group（36.67%）（P〈0.05）.After treatment,hearing threshold at each frequency of treatment group were significantly lower than before treatment（P〈0.05）.Conclusion： Nasal endoscopic adenoidectomy in the treatment of pediatric secretry otitis media has a satisfactory effect,little complication and can significantly improve the quality of children’s life.It is worthy of application in clinical.