不同手术联合方案对慢性分泌性中耳炎患者PTA及ABG的影响

Effects of different combined surgical regimens on PTA and ABG in patients with chronic secretory otitis media

目的探讨不同手术联合方案对慢性分泌性中耳炎患者纯音气导听阈(PTA)及气-骨导差(ABG)的影响。方法选取2018年2月至2019年8月本院收治的慢性分泌性中耳炎患者68例,按随机对照原则分为对照组(n=34,54耳)与观察组(n=34,53耳)。对照组采用腺样体消融术联合鼓膜切开置管术治疗,观察组在对照组基础上联合咽鼓管球囊扩张术治疗。比较两组治疗效果、PTA及ABG、咽鼓管功能及并发症情况。结果观察组治疗有效率(98.11%)高于对照组(85.19%),差异有统计学意义(P<0.05);术后,观察组PTA、ABG均低于对照组,差异有统计学意义(P<0.05);术后6个月、1年,观察组各时间点咽鼓管功能障碍问卷(ETDQ-7)评分均低于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较差异无统计学意义。结论腺样体消融术联合鼓膜切开置管术及咽鼓管球囊扩张术治疗慢性分泌性中耳炎,能有效提高患者术后咽鼓管功能,且安全性高,值得临床推广运用。

Objective To investigate the effects of different combined surgical regimens on the pure tone air conduction threshold(PTA)and air bone conductance(ABG)in patients with chronic secretory otitis media.Methods 68 patients with chronic secretory otitis media admitted to our hospital from February 2018 to August 2019 were randomly divided into control group(n=34,54 ears)and observation group(n=34,53 ears)accord-ing to the principle of randomized control.The control group was treated with adenoid ablation combined with tympanotomy and catheterization,and the observation group was treated with eustachian tube balloon dilation based on the control group.The treatment effect,PTA and ABG,eustachian tube function and complications were compared between the two groups.Results The effective rate of observation group(98.11%)was higher than that of control group(85.19%),the difference was statistically significant(P<0.05).PTA and ABG in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At 6 months and 1 year after surgery,the ETDQ-7 score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the in-cidence of postoperative complications between the two groups.Conclusion Adenoid ablation combined with tympanostomy and eustachian tube balloon dilation in the treatment of chronic secretory otitis media can effectively improve the postoperative eustachian tube function,and it is safe and worthy of clinical application.