腺样体切除联合鼓膜切开与置管在腺样体肥大合并分泌性中耳炎患儿手术治疗中的效果

Effect of adenoidectomy combined with tympanic membrane incision and indwelling catheter in the surgical treatment of children with adenoid hypertrophy complicated with secretory otitis media

目的研究腺样体切除联合鼓膜切开与置管在腺样体肥大合并分泌性中耳炎患儿手术治疗中的效果。方法选取2018年1月至2020年6月河池市第一人民医院耳鼻喉科收治的110例腺样体肥大合并分泌性中耳炎患儿作为研究对象,采用随机数字表法将其分为观察组(55例)和对照组(55例)。观察组患儿采用腺样体切除联合鼓膜切开抽液术治疗,对照组患儿采用腺样体切除联合鼓膜切开置管术治疗。比较两组患儿的治疗效果、并发症发生率、复发率。结果观察组的治疗总有效率为90.91%,与对照组的87.27%比较,差异无统计学意义(P>0.05);观察组患儿的并发症发生率(29.09%)高于对照组(9.09%),差异有统计学意义(P<0.05);随访6个月,观察组患儿的复发率(7.27%)高于对照组(0.00%),差异有统计学意义(P<0.05)。结论腺样体切除联合鼓膜切开抽液手术或联合鼓膜切开置管手术对腺样体肥大合并分泌性中耳炎患儿均有良好的手术疗效,但鼓膜切开置管术后患儿并发症更少,复发率更低,值得推广。

Objective To study the effect of of adenoidectomy combined with tympanic membrane incision and indwelling catheter in the surgical treatment of children with adenoid hypertrophy complicated with secretory otitis media.Methods A total of 110 children with adenoid hypertrophy complicated with secretory otitis media treated in the Department of Otolaryngology of the First People′s Hospital of Hechi City from January 2018 to June 2020 were selected as the research objects.They were divided into the observation group(55 cases)and the control group(55 cases)by random number table method.The children in the observation group were treated with adenoidectomy combined with tympanic membrane incision and drainage,and the children in the control group were treated with adenoidectomy combined with tympanic membrane incision and indwelling catheter.The treatment effect,the incidence rate of complication,and the recurrence rate of the two groups of children were compared.Results The total effective rate of the observation group was 90.91%,comp ared with 87.27%of the control group,the difference was not statistically significant(P>0.05).The incidence rate of complications in the observation group was 29.09%,which was higher than that of the control group accounting for 9.09%,the difference was statistically significant(P<0.05).Follow-up for 6 months,the recurrence rate of children in the observation group was 7.27%,which was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion Adenoidectomy combined with tympanic membrane incision and drainage or combined tympanic membrane incision and indwelling catheter have good surgical effects on children with adenoid hypertrophy complicated with secretory otitis media,but children with tympanic membrane incision and catheterization have fewer complications and lower recurrence rate,which is worthy of promotion.