耳内镜下鼓膜置管术治疗儿童分泌性中耳炎的效果及临床价值研究

Study on the Efficacy and Clinical Value of Endoscopic Tympanic Membrane Placement in the Treatment of Children with Secretory Otitis Media

目的分析耳内镜下鼓膜置管术治疗儿童分泌性中耳炎(ecretory otitis media,SOM)的临床疗效。方法随机选取该院2018年10月—2020年10月暨南大学附属顺德医院耳鼻咽喉头颈外科50例SOM患儿,通过随机数表法分组,参照组25例患儿采纳鼓膜穿刺术治疗,观察组25例患儿采纳耳内镜下鼓膜置管术治疗,两组临床疗效均在术后7 d评价,对比两组临床疗效、听力阈值、血清炎症指标、中耳积液消退时间、愈合时间、并发症总发生率、复发率。结果观察组临床总有效率(96.00%)与参照组(68.00%)相比较高,差异有统计学意义(χ^(2)=4.878,P<0.05);观察组治疗后骨导听力、气导听力阈值均低于参照组,差异有统计学意义(t=21.291、11.719,P<0.05);观察组治疗后血清PCT、TNF-α、IL-8均低于参照组,差异有统计学意义(t=9.886、11.212、7.007,P<0.05);观察组与参照组相比,中耳积液消退时间、愈合时间较短,差异有统计学意义(t=5.491、6.321,P<0.001)。观察组并发症总发生率(4.00%)与参照组(32.00%)相比较低,差异有统计学意义(χ^(2)=4.878,P<0.05)。观察组复发率(0.00%)与参照组(24.00%)相比较低,差异有统计学意义(χ^(2)=4.735,P<0.05)。结论耳内镜下鼓膜置管术可改善SOM患儿听力,促进中耳积液消退,减轻炎症反应,降低并发症发生率及复发率,疗效显著。

Objective To analyze the clinical effect of endoscopic tympanic tube placement in the treatment of children with secretory otitis media(SOM).Methods From October 2018 to October 2020,50 children with SOM in the Department of Otolaryngology and Head and Neck Surgery,Shunde Hospital Affiliated to Jinan University were randomly selected and randomly divided into groups.25 children in the reference group were treated with tympanic membrane puncture.25 children in the observation group were treated with endoscopic tympanic membrane tube placement,and the clinical efficacy of the two groups was evaluated 7 d after the operation.The clinical efficacy hearing threshold,serum inflammatory indexes,middle ear effusion resolution time,healing time,total incidence of complications and recurrence rate were compared between the two groups.Results Compared with the reference group(68.00%),the observation group had a higher total clinical effective rate(96.00%),the difference was statistically significant(χ^(2)=4.878,P<0.05).After treatment,the bone conduction hearing and air conduction hearing thresholds of the observation group were lower than those of the reference group,and the difference was statistically significant(t=21.291,11.719,P<0.05).After treatment,serum PCT,TNF-αand IL-8 in the observation group were lower than those in the reference group,and the difference was statistically significant(t=9.886,11.212,7.007,P<0.05).Compared with the control group,the observation group had a shorter time for the subsidence and healing time of ear effusion,and the difference was statistically significant(t=5.491,6.321,P<0.001).The total incidence of complications in the observation group(4.00%)was lower than that in the reference group(32.00%),the difference was statistically significant(χ^(2)=4.878,P<0.05).Compared with the reference group(24.00%),the recurrence rate(0.00%)of the observation group was lower,the difference was statistically significant(χ^(2)=4.735,P<0.05).Conclusion The tympanic membrane tube placement under otoscope can improve the hearing of children with SOM,promote the resolution of middle ear effusion,reduce the inflammatory response,and reduce the incidence of complications and recurrence,and the curative effect is significant.