咽鼓管吹张联合药物治疗分泌性中耳炎的疗效观察(1)
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[摘要] 目的 探讨咽鼓管吹张加注黏液溶解剂和糖皮质激素治疗分泌性中耳炎的临床疗效。 方法 将临床诊断为分泌性中耳炎的93例(157耳)患者随机分为观察组与对照组进行临床对照研究。 结果 观察组和对照组两组总有效率分别为96.15%和79.95%，观察组的总有效率明显优于对照组(P < 0.05)；两组治疗后PTA、ABG与较治疗前均明显下降，观察组明显低于对照组，差异有统计学意义(P < 0.05)；两组治疗后均无严重的并发症发生。 结论 咽鼓管吹张加注黏液溶解剂和糖皮质激素治疗分泌性中耳炎的疗效显著提高，促进分泌性中耳炎的恢复，且操作简单、安全，尤其适合于基层医院推广使用。
[关键词] 分泌性中耳炎；咽鼓管吹张；黏液溶解剂；糖皮质激素
[中图分类号] R764.21 [文献标识码] A [文章编号] 1674-4721(2012)04(a)-0071-03
Efficacy observation of the eustachian tube insufflation injecting slime lytic agent and glucocorticoid treatment for the secretory otitis media
YUE Yaoguang HUANG Heyin HUANG Lifang MENG Zhoujun DENG Simin
Hengli Hospital of Dongguan City in Guangdong Province, Dongguan 523460, China
[Abstract] Objective To discuss the clinical efficacy of eustachian tube insufflation injecting slime lytic agent and glucocorticoid treatment for the secretory otitis media. Methods Ninety-three patients (157ears) with secretory otitis media were diagnosed in the clinical, and randomly divided into observation group and control group to control study. Results The total effective rate of the observation group and the control group was 96.15% and 79.95%, the observation group was better than the control group, there was different statistical significance between them. The PTA and ABG of two groups after treatment were lower than before, the observation group was better, there was different statistical significance between two groups. There was no serious complication happening. Conclusion The eustachian tube insufflation injecting slime lytic agent and glucocorticoid treatment for the secretory otitis media can get the best efficacy, accelerate to resume secretory otitis media, it is easy to handle, safety, it is especially propitious to primary hospital to popularize using.
[Key words] Secretory otitis media; Eustachian tube insufflation; Slime lytic agent; Glucocorticoid
分泌性中耳炎(secretory otitis media，SOM)是以传导性聋及鼓室积液为主要特征的中耳非化脓性炎症性疾病，是耳鼻喉科的常见病[1]。目前认为主要与咽鼓管功能障碍、感染和免疫反应等有关，严重影响患者的生存质量[2]，若不及时采取有效的治疗措施，容易导致听力下降、言语障碍等严重并发症发生。解除咽鼓管通气障碍，改善中耳腔内负压状态，减少渗出，促进渗出液吸收和排出，是治疗SOM的重要措施[3]。为此，笔者于2009年4月～2011年4月采用激光+咽鼓管吹张+药物对SOM进行综合治疗，并取得较满意的疗效，现总结分析报道如下：
1 资料与方法
1.1 一般资料
93例(157耳)均为本科确诊的SOM患者，其中，男性51例(95耳)，女性42例(62耳)，年龄12～50岁 ......
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