许云　操润琴

【摘要】 目的：探讨幼儿耵聍栓塞采用改良式冲洗器治疗临床效果。方法：选择耵聍栓塞患儿80例，均为本院耳鼻咽喉科2015年2月-2016年2月收治，采用数字表抽取法随机分为两组，每组各40例。对照组采用传统冲洗器治疗，观察组采用改良式冲洗器治疗，比较两组的治疗效果。结果：观察组选取的耵聍栓塞患儿遵医依从率为95.0%，明显高于对照组80.0%，两组比较差异有统计学意义（P<0.05）。观察组患儿未出现外耳道黏膜、鼓膜受损，对照组5例（12.5%），两组比较差异有统计学意义（P<0.05）。观察组选取的患儿无眩晕呕吐，疼痛1例，不良反应发生率为2.5%；对照组眩晕呕吐3例，疼痛3例，不良反应发生率为15.0%，两组比较差异有统计学意义（P<0.05）。结论：针对临床耳鼻咽喉科收治的幼儿耵聍栓塞病例，采用改良式冲洗器治疗，与传统冲洗方法对比，可明显提高患儿遵医依从性，降低外耳道鼓膜、黏膜受损风险，且可防范疼痛、眩晕呕吐等不良反应，对保障预后价值显著。

【关键词】 改良式冲洗器； 幼儿； 耵聍栓塞； 效果观察

Improved Syringe Clinical Effect Observation of Treatment of Children Cerumen Embolism/XU Yun，CAO Run-qin.//Medical Innovation of China，2016，13（31）：109-112

【Abstract】 Objective：To study preschool cerumen embolization using improved syringe clinical treatment effect.Method：80 patients with cerumen embolism in our hospital otolaryngology department were selected from February 2015 to February 2016，they were randomly divided into two groups according digital table extraction method，40 cases in each group.The control group was given traditional syringe treatment，observation group was treated with modified syringe，the effects of two groups were compared.Result：The cerumen embolism children follow the medical compliance rate in observation group selection was 95.0%， significantly higher than the control group 80.0%， there was a significant statistical difference（P<0.05）.Observation group patients not in mucous membrane of the external auditory canal or tympanic membrane damaged， while control group had 5 cases（12.5%）， the difference was statistically significant（P<0.05）. In the observation group， there were no dizziness or vomiting， pain in 1 case， adverse reaction rate was 2.5%； control group， 3 cases of vertigo， 3 cases of pain， adverse reaction rate was 15.0%，the difference was statistically significant（P<0.05）.Conclusion：According to clinical otolaryngology treated infants cerumen embolism cases， treated by modified irrigator， compared with traditional washing method， can obviously improve children follow the medical compliance， reduce the external auditory canal tympanic membrane， mucosal damage risk， and can prevent the adverse reactions such as pain， dizziness and vomiting，to ensure significant prognostic value.

【Key words】 Improved syringe； Young children； Cerumen embolism； Results observation

First-authors address：Nanchang Integrated Traditional Chinese and Western Medicine Hospital，Nanchang 330003，China

doi：10.3969/j.issn.1674-4985.2016.31.032

耵聹栓塞是由外耳道内耵聍大量聚集，并凝结成块状，进而对外耳道造成阻塞所致，除影响听力外，还可诱发外耳道炎症及疼痛。相较成人外耳道，小儿外耳道较狭小，排除耵聍更为棘手，有更高的耵聍栓塞风险。针对耵聍深在、坚硬或因恐惧用耵聍钩取出耵聍而无法配合者，可采用外耳道冲洗法将耵聍冲出[1]。就诊时小儿易有负性心理反应，如自控力丧失、恐惧等，对冲洗器进行改良，可提高患儿遵医依从，最大程度改善预后，本次研究就此展开探讨，现将结果总结如下。endprint

1 资料与方法

1.1 一般资料 选取耵聍栓塞患儿80例，采用数字表抽取法随机分组，并经伦理学组织委员会批准。观察组40例，男25例，女15例，年龄1～6岁，平均（4.2±1.8）岁；对照组40例，男27例，女13例，年龄1～6岁，平均（4.3±1.6）岁。两组的一般资料比较差异均无统计学意义（P>0.05），具可比性。

1.2 纳入与排除标准 纳入标准：年龄10岁以下，与耵聍栓塞诊断标准符合；并经论理学组织委员会批准，患儿家属均自愿签署知情同意书。排……