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.

     

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