鼻内镜下腺样体切除术对SOM患儿并发症的影响

Effects of endoscopic adenoidectomy on complications of children with secretory otitis media

目的探讨鼻内镜下腺样体切除术在分泌性中耳炎(SOM)患儿中的应用效果。方法选择2019年1月至2022年5月收治的SOM患儿94例,根据随机数表法将其分为参考组和观察组,每组47例。参考组采用鼓膜置管术治疗,观察组予以鼻内镜下腺样体切除术联合鼓膜置管术治疗治疗。观察2组听力水平[听性脑干反应(ABR)阀值、ABRI波潜伏期]、疗效、炎性反应[C-反应蛋白(CRR)、肺瘤坏死因子α(TNF-α)]、复发及并发症发生情况。结果2组术后12个月ABR阈值和ABR I波潜伏期水平均较本组术前低,差异有统计学意义(P<0.05),但2组间比较差异无统计学意义(P>0.05);观察组总有效率稍高于参考组,但2组差异无统计学意义(P>0.05);2组术后3 d的血清CRP、TNF-α水平均低于本组术前,且观察组较参考组低,差异有统计学意义(P<0.05);观察组术后12个月的病情复发率及术后12个月内的并发症发生率均明显较参考组低,差异有统计学意义(P<0.05)。结论鼻内镜下腺样体切除术联合鼓膜置管术治疗SOM患儿的疗效确切,能够减轻SOM患儿炎性反应,并可减少病情复发及并发症发生率。

Objective To investigate the effect of endoscopic adenoidectomy on children with secretory otitis media(SOM).Methods A total of 94 children with SOM admitted to our hospital from January 2019 to May 2022 were selected.They were randomly divided into the reference group and observation group based on a random number table method,with 47 cases in each group.Children in both groups were treated with tympanic membrane catheterization,and those in the observation group were additionally treated with nasal endoscopic adenoidectomy.The listening level(auditory brainstem response[ABR]threshold,wave I latency of ABR),efficacy,inflammatory levels(C-reactive protein[CRP],tumor necrosis factor alpha[TNF-α]),recurrence and complications were compared between groups.Results The ABR threshold and wave I latency of ABR I at 12 months after surgery in both groups were significantly lower than those before surgery(P<0.05),but there were no significant differences between the two groups(P>0.05).The total effective rate of the observation group was slightly higher than that of the reference group without a significant difference(P>0.05).Serum CRP and TNF-αat 3 days after surgery were significantly lower than those before surgery,which were significantly lower in the observation group than those of reference group(P<0.05).The recurrence rate and incidence of complications within 12 months after surgery in the observation group were significantly lower than those of the reference group(P<0.05).Conclusion Nasal endoscopic adenoidectomy combined with tympanic membrane catheterization is effective in the treatment of children with SOM,which can reduce the inflammatory response,recurrent rate and incidence of complications.