腺样体手术患儿分泌性中耳炎的临床特征及疗效分析

Clinical Features and Efficacy Analysis of Endocrine Otitis Media in Children Undergoing Adenoid Hypertrophy Surgery

目的 探究腺样体肥大手术患儿分泌性中耳炎临床特征及不同手术的治疗效果。方法 选取2019年12月—2022年12月常州市儿童医院耳鼻喉科收治的2210例腺样体肥大手术患儿,依据临床资料(术中诊断)将患儿分为分泌性中耳炎组233例和无分泌性中耳炎组1977例,比较其临床特征;分泌性中耳炎组根据术式分为鼓膜切开组211例和鼓室置管组22例,比较治愈率。结果 腺样体手术患儿分泌性中耳炎组不同性别、不同腺样体与鼻咽腔比值发病率与无分泌性中耳炎组比较,差异均无统计学意义(P>0.05),分泌性中耳炎组不同年龄发病率与无分泌性中耳炎组比较,差异有统计学意义(P<0.01);分泌性中耳炎患儿鼓膜切开组治愈率与鼓室置管组比较,差异无统计学意义(P>0.05)。结论 分泌性中耳炎术前诊断需要结合声导抗、电测听、耳内镜综合判断;年龄影响腺样体肥大患儿分泌性中耳炎的发病率;在充分处理咽鼓管咽口阻塞的情况下,鼓膜切开治疗与鼓室置管治疗疗效相当。

Objective To analyze the clinical characteristics of secretory otitis media in children with adenoid hypertrophy who require surgery and the efficacy of different surgical methods.Methods The data of 2210 hospitalized children with adenoidal hypertrophy admitted to the Otolaryngology Department of Changzhou Children's Hospital from December 2019 to December 2022 were selected.According to the clinical data(intraoperative diagnosis),the children were divided into secretory otitis media group(233 cases)and nonsecretory otitis media group(1977 cases),and their clinical characteristics were compared.The secretory otitis media group was divided into tympanic membrane incision group or tympanic tube insertion group according to the intraoperative treatment,and the difference in their cure rate was compared.Results There was no significant difference in the incidence rate of secretory otitis media in terms of gender and A/N value(P>0.05),but there was significant difference in terms of age(P<0.01),there was no statistically significant difference in the cure rate between tympanic membrane incision and tympanic tube placement in children with secretory otitis media(P>0.05).Conclusion Preoperative diagnosis of secretory otitis media requires a comprehensive assessment of acoustic impedance,electrical audiometry,and otoscopy;Age difference affects the incidence rate of secretory otitis media in hospitalized children with adenoidal hypertrophy;In the case of sufficient treatment of pharyngeal obstruction of the eustachian tube,the therapeutic effect of tympanic membrane incision treatment is equivalent to that of tympanic tube placement treatment.