急性化脓性中耳炎合并慢性鼻窦炎的临床治疗观察

Clinical Observation of Acute Suppurative Otitis Media with Chronic Sinusitis

目的分析探讨急性化脓性中耳炎合并慢性鼻窦炎治疗效果、临床意义以及注意事项。方法对我院2007年6月至2011年6月84例急性化脓性中耳炎合并慢性鼻窦炎患者随机平均分为观察组和对照组。对照组患者急性期根据鼓膜穿孔情况给予局部治疗,观察组患者急性期在局部治疗基础上,给予上颌窦穿刺冲洗、负压置换治疗,必要时行鼻腔手术。分析比较两组患者临床治疗效果以及远期复发情况。结果观察组42例患者治疗有效率、复发率平均住院治疗日明显优于对照组42例患者,说明差异存在统计学意义。观察组29例鼓膜未穿孔患者治疗过程中鼓膜穿孔率与对照组32例鼓膜未穿孔患者治疗过程中鼓膜穿孔率无明显统计学差异(P>0.05)。结论急性化脓性中耳炎合并慢性鼻窦炎患者由于局部感染控制不佳,咽鼓管引流不畅等因素,治疗后极易反复发作,因此临床上应结合病因给予综合治疗。

Objective Analysis to investigate the precautions and treatment of acute suppurative otitis media with chronic sinusitis,the clinical significance.Method Since June 2007 to June 2011,84 cases of acute suppurative otitis media with chronic sinusitis patients were randomly divided into observation group and control group.Control group of patients according to the tympanic membrane perforation with topical treatment,observation group of patients with topical treatment on the basis,to give the maxillary sinus puncture,vacuum replacement in the treatment,nasal surgery,if necessary.The two groups were compared clinical outcomes in patients with long-term recurrence.Results 42 patients were treated in the observation group efficiency,the average recurrence rate of hospitalization better than the control group of 42 patients,P 0.05,indicating the differences statistically significant.Observer Group of 29 cases with no tympanic membrane perforation in the course of treatment developped with perforation rate to control group 32 cases of with no tympanic membrane perforation the rate with no significant statistical difference（P0.05）.Conclusion Acute suppurative otitis media with chronic sinusitis due to poor control of local infection,eustachian tube drainage and other factors,the treatment of highly recurrent episodes,should be combined with clinical etiology given comprehensive treatment.