咽鼓管测压对儿童分泌性中耳炎疗效评估的价值

The Function of Tubomanometry in Forecasting the Prognosis of Otitis Media with Effusion in Children

目的探讨儿童分泌性中耳炎(otitis media with effusion,OME)治疗前后咽鼓管测压(tubomanometry,TMM)对预测OME预后的价值。方法 66例(98耳)OME患儿(中耳炎组,其中单耳34例,双耳32例)分别在治疗前及正规药物治疗后1月内进行声导抗和TMM测试,记录鼓室导抗图类型及咽鼓管评分(eustachian tube scores,ETS)值,并比较二者之间关系,以单耳患者的正常耳(34耳)作为正常对照组。结果治疗前,中耳炎组ETS平均值(2.27±1.98分)低于正常对照组(5.14±0.98分)(P<0.01),鼓室导抗图B型耳的ETS平均值(1.70±1.68分)低于C型耳(3.02±2.11分)(P<0.01)。治疗后中耳炎组ETS平均值(3.62±1.85分)显著高于治疗前(P<0.05),但治疗后鼓室导抗图B型耳的ETS平均值(3.58±1.69分)与C型耳(3.98±1.45分)差异无统计学意义(P>0.05),B型耳的ETS提高值(1.84±1.7分)高于C型耳(0.72±0.03分)(P<0.05)。无论B型耳还是C型耳,有效组治疗前后ETS平均值及治疗前后ETS差值均高于无效组(P<0.01)。结论儿童分泌性中耳炎患耳治疗后ETS值提高,咽鼓管功能改善;治疗前鼓室导抗图B型耳的ETS值较C型耳低,治疗后B型耳的ETS提高值高于C型耳;TMM可为临床评估儿童OME预后提供一定参考。

Objective To study the relationship between tubomanometry(TMM)and tympanograms before and after the treatment of otitis media with effusion(OME)in children,and to evaluate the function of tubomanometry in forecasting the prognosis of OME.Methods Data from 66 patients(98 ears)were collected before and after one to four weeks treatment,all the patients received tympanometry and tubomanometry ETS,recorded eustachian tube scores(ETS)and tympanogram types.Results Before treatment,there were significant differences between the ETS of normal ears and sick ears,also between ETS of type B tympanograms and type C.There was significant difference between ETS before and after treatment,but not between the ETS of type B tympanograms and type C after treatment.The increased ETS value of type B tympanograms was higher than type C with a significant difference.There was a significant difference between the ETS of the effective group and the invalid group before and after treatment,whether type B tympanograms or type C.Conclusion Eustachian tube scores increased after treatment,and the functions of eustachian tube were improved in children of otitis media with effusion.Before treatment,the ETS of type B tympanograms was lower than type C,indicating apoorer function of eustachian tube.After treatment,the increased ETS value of type B tympanograms was more than type C.Tubomanometry could forecast the prognosis of otitis media with effusion in children.