低温等离子鼓膜造孔治疗慢性分泌性中耳炎的临床观察

Application of Low Temperature Plasma Tympanostomy in Chronic Secretory Otitis Media

目的目的探索耳内镜下低温等离子鼓膜造孔术在治疗慢性分泌性中耳炎中的作用,比较造单孔和双孔的疗效差异。方法分析研究药物保守治疗2月且经过反复鼓膜穿刺均无效的慢性分泌性中耳炎成年患者行鼓膜打孔治疗,单孔组(25例)、双孔组(21例)。统计分析两组的治愈率、复发率、感染率、鼓膜造孔留存时间、鼓室积液清除时间及疼痛量表。结果两组鼓膜造孔均愈合,但双孔组的鼓膜造孔留存时间明显长于单孔组,P<0.001。两组的治疗有效率均大于90%,但双孔组的治愈率要高于单孔组,P<0.05。两组复发率、感染率、疼痛量表无明显统计学差异。结论耳内镜下低温等离子鼓膜造孔是一种疗效肯定且易于推广的慢性分泌性中耳炎的治疗方法。在条件允许前提下,造双孔有更明显的优势。

Objective To explore the effect of low-temperature plasma tympanostomy with endoscope and to compare the curative effect of single-hole and double-hole in treating chronic secretory otitis media(SOM).Methods Analyze and study the treatment of chronic SOM by tympanic membrane perforation(TMP)in adult patients who received ineffective therapy of either conservative drug therapy for 2 months or repeated tympanic membrane puncture.TMP was performed in 25 cases of single-hole group and 21 cases of double-hole group.The cure rate,recurrence rate,infection rate,tympanostomy retention time,tympanic effusion clearance time and pain scale were analyzed.Results TMP healed in both groups,but the retention time of TMP in double-hole group was significantly longer than that in single-hole group(P<0.001).The effective rate of the both groups was more than 90%,but the cure rate of the double-hole group was higher than that of the single-hole group,P<0.05.There was no significant difference in recurrence rate,infection rate and pain scale between the two groups.Conclusion Low-temperature plasma tympanostomy with endoscope is an effective and easy-to-popularize treatment for CSOM.If condition permits,the double hole has its obvious advantages.