耳内镜下鼓膜置管术在药物治疗无效的儿童分泌性中耳炎治疗中的应用效果

Application of ear endoscope in the treatment of secretory otitis media in children with ineffective drug therapy

目的：探讨药物治疗无效的儿童分泌性中耳炎患者耳内镜下鼓膜置管手术效果。方法选择80例药物治疗无效的儿童分泌性中耳炎患者作为研究对象，按照随机数字表法将所有患者分为观察组和对照组，每组40例，观察组患者采用耳内镜下鼓膜置管术进行治疗，对照组采用耳内镜下鼓膜穿刺术进行治疗，观察两组患者的复发、临床疗效和术后并发症情况。结果观察组复发率为5．00％，对照组复发率为20.00％，两组比较差异有统计学意义（χ2＝4．114，P＝0.042），观察组的中耳积液时间为（8．53±1．25）d，对照组为（10．46±1．44）d，两组比较差异有统计学意义（t＝5．074，P＝0．000）；观察组有37例患者治疗后有所变化，总有效率为92．50％，对照组有28例患者治疗后有所变化，总有效率为70．00％，观察组的总有效率明显高于对照组，差异有统计学意义（χ2＝6．646，P＝0.009）；观察组并发症发生率为7．50％，对照组并发症发生率为32．50％，观察组的并发症发生率明显低于对照组，差异有统计学意义（χ2＝7．812，P＝0．005）。结论采用耳内镜下鼓膜置管手术，对药物治疗无效的儿童分泌性中耳炎患者进行治疗，其临床疗效显著，复发率相对更低，并发症发生的情况更少，高效安全，值得临床推广应用。

Objective To investigate the application of ear endoscope in the treatment of secretory otitis media in children with ineffective drug therapy.Methods 80 secretory otitis media children with ineffective drug therapy were selected as the research subjects.According to the random number table method,all patients were divided into treatment group and control group,40 cases in each group.The observation group received otoendoscopic tympanic membrane tube surgery treatment,the control group received auripucture with otic endoscope surgery treatment.The complications of the two groups were observed,and the clinical curative effect and postoperative recurrence were compared.Results The recurrence rate of the observation group was 5 .00%,which was significantly lower than 20.00% of the control group （χ2 =4.114,P=0.042）.The middle ear effusion time of the observation group was （8.53 ±1.25）d,which was significantly shorter than （10.46 ±1.44）d of the control group （t=5.074,P=0.000）. In the observation group,37 patients after treatment had change,the total effective rate was 92.50%.In the control group,28 patients after treatment had change,the total effective rate was 70.00%,the total effective rate of the observation group was significantly higher than the control group,the difference was statistically significant （χ2 =6.646,P=0.009）.The incidence rate of complication in the observation group was 7.50%,which was significantly lower than 32.50% in the control group （χ2 =7.812,P=0.005 ）.Conclusion Tympanostomy tube under ear endoscope surgery for the treatment of drug refractory secretory otitis media in children has good effect,the recurrence rate is relatively lower,has less complications,high safety,it is worthy of clinical application.