鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗治疗慢性分泌性中耳炎临床观察
Clinical Observation on the Treatment of Chronic Secretory Otitis Media by Nasal Endoscope Assisted Salpingocatheterism Combined with Chinese Medicine Liquid Irrigation
-
摘要: 目的 观察鼻内镜下咽鼓管置管联合鼓室中药液冲洗治疗慢性分泌性中耳炎(CSOM)的治疗效果。方法 将2012年9月-2014年3月期间就诊的80例CSOM 患者随机分成2组。实验组40例(61 耳)行经鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗,每次2 mL,4~7 d。对照组40例(59耳)行鼓膜切开置管,置入管通常6~8 周后取出或自行掉落。术后随访6月,观察2组疗效。 结果 实验组治愈率为81.97%,总有效率为95.08%,优于对照组(64.41%、83.05%),P<0.05。实验组并发症发生率为9.84%,低于对照组(28.81%),P<0.05。实验组复发率为6.56%,低于对照组(20.34%),P<0.05。结论 鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗治疗慢性分泌性中耳炎,创伤小、疗效确切、副反应少、复发率低,值得临床推广。Abstract: OBJECTIVE To study the clinical effect of Salpingocatheterism combined with Chinese medicine liquid irrigation under endoscope for chronic secretory otitis media (CSOM). METHODS From September 2012 to March 2014, 80 patients with CSOM(120 ears) in the clinic were randomly divided into two groups. The experimental group:40 cases(61ears) were treated with Salpingocatheterism combined with Chinese medicine liquid irrigation and the liquid named Qingqiao tang(empirical recipe) was injected for 4 to 7days with 2ml each time. The control group:40 cases(59ears) were treated by myingotomy with grommet insertion. The ventilation tube was generally pulled out after 6 to 8 weeks or dropped out by itself .All patients were followed up for 6 months and the effects were to be evaluated. RESULTS In the experimental group,among 61ears, 50 ears were cured,6 showed effectual results, 2 were positive to the treatment and 3 showed ineffective results. The cure rate was 81.97% and the total effective rate was 95.08% .In the control group,among 59 ears, 38 ears were recovered, 6 showed effectual results, 5 were positive to the treatment,10 showed ineffective results. The cure rate was 64.61% and the total effective rate was 83.05% . The therapeutic effect of experimental group was better than that of the control group. The complication rate of the experimental group was 9.84%,while the control group was 28.81%. The complication rate of the experimental group was significantly lower than that of the control group. The recurrence rate of the experimental group was 6.56% while the control group was 20.34%, the recurrence rate in the control group was significantly higher than that of the experimental group. The differences both had statistical significance (P<0.05). CONCLUSION The treatment of CSOM with salingocatheterism combined with Qingqiao tang irrigation under endoscope is effective and causes little injury. With a low recurring rate and less adverse reaction, this treating method is worth of being applied widely.
-
Key words:
- CSOM /
- salpingocatheterism /
- auripuncture /
- Qingqiao tang
-
[1] 孔维佳,周梁.耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2008:116. [2] Kong WJ, Zhou L. Otorhinolaryngology head and neck surgery[M]. Beijing: People's medical publishing house, 2008:116. [3] Kalu SU, Hall MC. A study of clinician adherence to treatment guidelines for otitis media with effusion[J]. Wisc Med J, 2010, 109(1): 15-20. [4] 崔少云,梁耀基,梁健刚,等.电视监视鼻内镜下咽鼓管吹张、插管注药治疗慢性分泌性中耳炎[J].中国中西医结合耳鼻咽喉科杂志,2006, 14(2):98-99. [5] Cui SY, Liang YJ, Liang JG, et al.Eustachian tube insufflation and intubation with drug with the assistance of TV monitoring nasal endoscopy in treating chronic secretory otitis media[J].Chin J Otorhinolaryngol Integr Tradit West Med, 2006, 14(2): 98-99. [6] Ryding M, White P, Kalm O. Eustachian tube function and tympanic membrane findings after chronic secretory otitis media[J]. Int J Pediatr Otorhinolaryngol, 2004, 68(2):197-204. [7] Keereweer S, Metselaar RM, Dammers R, et al. Chronic serous otitis media as a manifestation of temporal meningioma[J]. ORL J Otorhinolaryngol Relat Spec, 2011, 73(5): 287-290. [8] Slavinskii AA, Semenov FV. Disputable aspects of the problem ofexudative otitis media [J]. Vestn Otorinolaringol, 2006(2):62-65. [9] Anon JB. Current management of acute bacterial rhinosinusitis and the role of moxifloxacin[J]. Clin Infect Dis, 2005, 41(Suppl 2): S167-S176. [10] Van Zele T, Claeys S, Gevaert P, et al. Differentiation of chronic sinus diseases by measurement of inflammatory mediators[J]. Allergy, 2006, 61(11): 1280-1289. [11] 陈争明,许益飞,韩小江,等.鼻内镜下曲安奈德冲洗咽鼓管治疗慢性分泌性中耳炎[J].听力学及言语疾病杂志,2011, 19(1):68-69. [12] Chen ZM, Xu YF, Han XJ, et al. Nasal endoscope assisted flushing of the eustachian tube with Triamcinolone in treating chronic secretory otitis media[J]. J Audiol Speech Pathol, 2011, 19(1):68-69. [13] 张武宁,唐安洲,徐志文,等.分泌性中耳炎咽鼓管功能动态观察的临床意义[J].山东大学基础医学院学报,2005,19(1):7-9. [14] Zhang WN, Tang AZ, Xu ZW, et al. Clinical significance of observatino of the functional change of eustachian tube of secretory otitis media[J]. J Shandong Univ Bases Med, 2005, 19(1):7-9. [15] 冯晓华,龙孝斌,汪建,等.中耳乳突手术治疗骨导听力下降的分泌性中耳炎[J].南方医科大学学报,2010, 30(7):1673-1675. [16] Feng XH, Long XB, Wang J, et al. Mastoid surgery for secretory otitis media with mixed hearing loss[J]. J South Med Univ, 2010, 30(7): 1673-1675. [17] 郭亿莲,孙一帆,张丽娟,等.中耳共振频率测试在儿童分泌性中耳炎诊断中的意义[J].广东医学,2012, 33(16):2452-2454. [18] Guo YL, Sun YF, Zhang LJ, et al. Clinical significance of the middle ear resonant frequency test in the diagnosis of children's secretory otitis media[J]. Guangdong Med J, 2012, 33(16): 2452-2454. [19] 朱锦州,王耀洪.纤维镜下咽鼓管吹张治疗分泌性中耳炎观察[J].中国内镜杂志,2003, 9(4):61-62. [20] Zhu JZ, Wang YH. Observation of the tuba auditiva insufflation treating secretory otitis media under fibrescope[J]. Chin J Endoscopy, 2003, 9(4): 61-62. [21] 李希平,戴海江,牟文清.分泌性中耳炎的治疗现状与思考[J].中国耳鼻咽喉头颈外科,2007, 14(8):467-469. [22] Li XP, Dai HJ, Mu WQ. Reflection on the treatment of secretoroy otitis media[J]. Chin J Otorhinolaryngol Head Neck Surg, 2007, 14(8):467-469. [23] Kaneko Y, Takasaka T, Sakuma M, et al. Middle ear inflation as a treatment for secretory otitis media in children[J]. Acta Otolaryngol, 1997, 117(4): 564-568. [24] Fields MJ, Allison RS,Corwin P, et al.Microtympanometry,microscopy tympanometry in evaluating middle ear effusion prior to myringotomy[J]. N Z Med J, 1993, 106: 386-387. [25] 杨国存,胡建文,曾一民.鼻内镜下行咽鼓管置管药物冲洗治疗分泌性中耳炎[J].中国微创外科杂志,2006, 6(10):791-792. [26] Yang GC, Hu JW, Zeng YM. Tube placement and drug irrigation in the auditory tube under nasoscope for the treatment of secretory otitis media[J]. Chin J Minimally Invasive surg, 2006, 6(10): 791-792. [27] Sun YD, Chen LH, Hu WJ, et al. Evaluation of the clinical efficacy of Qingqiao capsule in treating patients with secretory otitis media[J].Chin J Integr Tradit West Med,2005,11(4):243-248.
点击查看大图
计量
- 文章访问数: 1201
- HTML全文浏览量: 3
- PDF下载量: 1163
- 被引次数: 0