慢性中耳炎患者改良乳突根治术后不干耳的术前因素分析

A Study on the Risk Factors for Otorrhea after Modified Radical Mastoidectomy

目的探讨与改良乳突根治术后不干耳相关的术前影响因素。方法回顾性分析2008年1月～2012年1月90例行改良乳突根治术的慢性化脓性中耳炎患者的临床资料,应用多自变量Logistic回归分析法评估研究对象的年龄、病程、性别、药物过敏史、吸烟史、中耳炎类型、鼻咽部炎症情况以及致病菌等8个可能影响乳突根治术后不干耳的因素。结果 90例患者中术前有吸烟史、骨疡型中耳炎及致病菌为真菌者术后不干耳的发生率分别为28.0%(7/25)、18.60%(8/43)和40.0%(6/15),分别高于术前无吸烟史(4.62%,3/65)、表皮样瘤型中耳炎(4.26%,2/47)、致病菌为常见细菌(5.33%,4/75)者(P<0.05)。Logistic回归分析显示吸烟、骨疡型中耳炎、真菌感染为乳突根治术后不干耳的术前影响因素,OR值分别为7.638、7.937和10.637。结论吸烟、骨疡型中耳炎、真菌感染患者乳突根治术后不干耳的危险性相对较高,为改善手术预后,需做好充分术前准备。

Objective To study the possible preoperative risk factors for otorrhea in patients underwent radical mastoidectomy.Methods This was a retrospective study carried out among 90patients with chronic suppurative otitis media（CSOM）,who had underwent modified radical mastoidectomy during January 2008to January 2012.Total of 8possible risk factors such as age,course of disease,sex,allergic history,smoking history,CSOM type,nasopharynx condition and pathogenic bacteria were studied.The data were analyzed and multi-variable logistic regression analysis was applied.Results χ2test showed differences in smoking history group,CSOM type group and pathogenic bacteria group（P=0.002,0.030,0.000）.Logistic regression analysis confirmed the interrelation between those factors and otorrhea.Conclusion Smoking,CSOM and fungous infection are the risk factors for otorrhea in patients underwent radical mastoidectomy.