医师耳内异物取出术熟练度与术后并发症发生率相关性分析

Correlation analysis between physician’s proficiency in removal of foreign body in ear and incidence of postoperative complications

目的探讨医师耳内异物取出术熟练度与术后并发症发生率相关性,为临床治疗和相关并发症预防提供一定参考。方法从山东省医疗卫生系统中抽取几所二级、三级医院,回顾性分析2015年至2019年收治的246例耳内异物患者,分析医师耳内异物取出术熟练度与术后并发症发生率之间的相关性。结果 246例耳内异物患者中只有79例(32.11%)在异物插入12h内提交给耳鼻喉科医师。共有46名患者(18.70%)最初曾接受非耳鼻喉科医师非熟练的耳内异物取出,其中46人共发生62例术后并发症:其中23例外耳道擦伤、裂伤和/或出血,15例外耳炎,9例鼓膜穿孔,7例听力受损,5例慢性化脓性中耳炎,3例中耳受累。在最初由耳鼻喉科医师行耳内异物取出的200例患者中,只有11例出现并发症:8例外耳道擦伤、裂伤和/或出血,3例外耳炎。耳鼻喉科医师与非鼻喉科医师治疗的患者总体术后并发症发生率差异有统计学意义(P<0.05)。结论医师耳内异物取出术熟练度与术后并发症发生率具有相关性,耳内异物取出术不熟练的非耳鼻喉医师尝试后可能会导致术后可预防并发症的发生。

Objective To explore the correlation between doctors’ proficiency in removing foreign bodies in ears and the incidence of postoperative complications,so as to provide some reference for clinical treatment and prevention of related complications.Methods From several secondary and tertiary hospitals in Shandong Province,246 patients with foreign bodies in the ear treated from 2015 to 2019 were analyzed retrospectively,and the correlation between doctors’ proficiency in removing foreign bodies in the ear and the incidenc e of postoperative complications was analyzed.Results Only 79 cases (32.11%) of 246 patients with foreign bodies in the ear were submitted to otolaryngologists within 12 hours after the foreign bodies were inserted.A total of 46 patients (18.70%) had received the removal of foreign bodies in their ears by unskilled otolaryngologists at first.Among them,46 patients had 61 postoperative complications,including 23 cases of external auditory canal abrasion,laceration and/or hemorrhage,15 cases of otitis externa,9 cases of tympanic membrane perforation,7 cases of hearing loss,4 cases of chronic suppurative otitis media and 3 cases of middle ear involvement.Of the 200 patients who were initially removed by otolaryngologists,only 11 had complications:8 cases of external auditory canal abrasion,laceration and/or hemorrhage,and 3 cases of otitis externa.The incidence of postoperative complications between otolaryngologists and non-otolaryngologists was significantly different (P<0.05).Conclusions There is a correlation between doctors’ proficiency in removal of foreign bodies in ears and the incidence of postoperative complications.Non-otolaryngologists who are unskilled in removal of foreign bodies in ears may lead to preventable postoperative complications.