张凯铭 周庆明

【摘要】 目的：探討应用耳内镜下鼓膜置管术治疗分泌性中耳炎的症状改善情况。方法：选择2017年10月-2019年10月笔者所在医院56例分泌性中耳炎患者作为研究对象，随机将患者分为鼓膜穿刺组与鼓膜置管组，各28例，鼓膜穿刺组行耳内镜下鼓膜穿刺手术治疗，鼓膜置管组行耳内镜下鼓膜置管术治疗，对比两组患者听力改善情况、中耳积液持续时间、疾病的复发率和穿孔、鼓室硬化、感染等并发症发生率。结果：鼓膜置管组气导听阈、气骨导差显著低于鼓膜穿刺组与术前（P<0.05）;鼓膜置管组中耳积液持续时间显著短于鼓膜穿刺组（P<0.05）。鼓膜置管组疾病的复发率及穿孔、鼓室硬化、感染等并发症发生率显著低于鼓膜穿刺组（P<0.05）。结论：分泌性中耳炎行耳内镜下鼓膜置管术治疗能够显著改善患者术后听力，加速中耳积液消失，降低疾病的复发率，促进患者的恢复，减少并发症的发生。

【关键词】 耳内镜下鼓膜置管术 分泌性中耳炎 症状改善情况

doi：10.14033/j.cnki.cfmr.2020.13.019 文献标识码 B 文章编号 1674-6805（2020）13-00-02

Improvement of Symptoms in the Treatment of Secretory Otitis Media with Tympanic Membrane Catheterization under Otoendoscopy/ZHANG Kaiming， ZHOU Qingming. //Chinese and Foreign Medical Research， 2020， 18（13）： -49

[Abstract] Objective： To investigate the improvement of symptoms in the treatment of secretory otitis media by tympanic membrane catheterization under otoendoscopy. Method： A total of 56 patients with secretory otitis media from October 2017 to October 2019 in our hospital were randomly divided into eardrum puncture group and eardrum catheterization group. 28 patients in each. Eardrum puncture group was treated by eardrum puncture under eardrum endoscope， eardrum catheterization group was treated by eardrum catheterization under eardrum endoscope. The hearing improvement， the average time of middle ear effusion， the recurrence rate of disease， the incidence of complications such as perforation， tympanosclerosis and infection were compared between the two groups. Result： The air conduction threshold and the air bone conduction difference of the eardrum puncture group were significantly lower than those of the eardrum catheterization group and the indexes of preoperative （P<0.05）. The average time of middle ear effusion in the eardrum puncture group was significantly shorter than that in the eardrum catheterization group （P<0.05）. The recurrence rate and the incidence of complications such as perforation， tympanosclerosis and infection of eardrum catheterization group were significantly lower than those of eardrum puncture group （P<0.05）. Conclusion： The treatment of tympanic membrane catheterization under otoendoscopy for secretory otitis media can significantly improve the postoperative hearing， accelerate the disappearance of effusion in the middle ear， reduce the recurrence rate of the disease， promote the recovery of the patients， and reduce the incidence of complications.

[Key words] Tympanic membrane catheterization under otoendoscopy Secretory otitis media Symptom improvement

First-authors address： Aviation General Hospital， China Medical University， Beijing 100012， China

分泌性中耳炎是临床较为多见的耳科疾病，会损坏中耳结构，导致听力减弱，鼓膜穿孔还会引发耳鸣。临床治疗分泌性中耳炎的基本原则是消除病灶、控制感染、改善听力及通畅引流等[1-2]。本次研究主要目的是探讨应用耳内镜下鼓膜置管术治疗分泌性中耳炎的症状改善情况，选择2017年10月-2019年10月笔者所在医院56例分泌性中耳炎患者作为研究对象，随机分组后对比鼓膜穿刺组与鼓膜置管组患者听力改善总有效率、中耳积液的平均时间、疾病的复发率、出现穿孔、鼓室硬化、感染的发生率，取得满意效果，现报告如下。

1 资料与方法

1.1 一般资料

选择2017年10月-2019年10月笔者所在医院56例分泌性中耳炎患者作为研究对象，纳入标准：符合分泌性中耳炎诊断标准。排除标准：合并其他耳鼻喉科疾病的患者、存在手术禁忌的患者。……