新型双腔鼓室和咽鼓管冲洗管联合药物治疗分泌性中耳炎的疗效观察陈争明陈步磊许益飞朱元奉【摘要】目的探讨鼻内镜下使用新型双腔鼓室和咽鼓管冲洗管,辅以曲安奈德冲洗鼓室、咽鼓管治疗分泌性中耳炎的疗效。方法2009年8月至2011年7月来我科就诊的45例分泌性中耳炎患者,经知情同意后采用数字表法随机分为对照组和治疗组。治疗组25例36耳,鼻内镜下将新型双腔鼓室、咽鼓管冲洗管置入咽鼓管,辅以曲安奈德冲洗鼓室和咽鼓管;对照组20例30耳,行鼓膜穿刺,鼓室内注射地塞米松、d一糜蛋白酶予以治疗。结果治疗组治愈25耳(69.4%),好转5耳(13.9%),总有效率83.3%。对照组治愈22耳(73.3%),好转2耳(6.7%),总有效率80.O%。2组比较差异无统计学意义(P>0.05)。治疗组首次治疗有效26耳(72.2%),对照组首次治疗有效21耳(70.0%),2组比较差异无统计学意义(P>0.05)。治疗组耳痛、眩晕、鼓膜瘢痕、中耳炎感染等不良反应发生率与对照组比较差异均有统计学意义(P<0.05)。术后1个月内治疗组复发5耳(13.9%),对照组复发11耳(36.7%),2组比较差异有统计学意义(P<0.05)。结论新型双腔鼓室和咽鼓管冲洗管可以取样、抽吸、冲洗,将其置入咽鼓管,辅以曲安奈德冲洗鼓室和咽鼓管,可以起到清除鼓室及咽鼓管积液、消除肿胀、改善黏膜功能的作用,其治疗分泌性中耳炎的疗效与传统鼓膜穿刺给药法疗效相仿,但术后耳痛少,复发率低,不良反应少。【关键词】鼓室;咽鼓管;冲洗管;分泌性中耳炎Observationontheeffectofcomprehensivetreatmentonsecretoryotitiswiththenewtypedual·tunnel-eustachian-washingtubeCHENZheng—ruing4,CHENBu—lei,xUYi母i,ZHUYuan母ng.4DepartmentofOtolaryngology,No.411Hospital,CPLA,Shanghai200081,ChinaCorrespondingauthor:CHENBu—lei,E—mail:zhengmingchen@126.com【Abstract】objectiveToinvestigatetheeffectofcomprehensivetreatmentwithtriamcinoloneacetonideonsecretoryotitiswiththenewtypedual—tunnel—eustachian—washingtube.MethodsForty—fivepatientswithsecretoryotitis,whosoughtmedicalhelpinthehospitalfromAugust2009toJuly2011,werechosenanddividedintothecontrolgroupandthetreatmentgroup,withknowledgeandagreementofthepatients.Therewere25cases(36ears)inthetreatmentgroup.Thenewtypedual—tunnel—eustachian—washingtubewasplacedintheeustachiantubeunderthenasalendoscopeandwashedtympaniccavityandeustachiantubewithtriamcinoloneacetonide.Inthecontrolgroup,therewere20cases(30ears),thatreceivedauripuctureandinjectionofmethylprednisoloneand仅一chymotrypsininthetympaniccavity.ResultsInthetreatmentgroup,25earswerecured(accountingfor69.4%)and5earsimproved(accountingfor13.9%),withatotaleffectiverateof83.3%.Inthecontrolgroup,22earswerecured。(accountingfor73.3%)and2earsimproved(accountingfor6.7%),withatotaleffectiverateof80.O%.Nostatisticalsignificancecouldbenoted,whencomparisonsweremadebetweenthe2groups(P>0.05).Inthetreatmentgroup,26earspositivelyrespondedtofirsttreatment(accountingfor72.2%),whileinthecontrolgroup21earsrespondedtofirsttreatment(accountingfor70.0%).Nostatisticaldifferencecouldbeseen,whencomparisonsweremadeDOI:10.3760/cma.j.issn.1009—6906.2012.04.0l1作者单位:200081上海,解放军第四一一医院耳鼻咽喉科(陈争明、许益飞、朱元奉);解放军92118部队医院耳鼻咽喉科(陈步磊)通信作者:陈步磊,电子邮箱:zhengmingchen@126.corn·227·.论著万方数据分泌性中耳炎是指因中耳腔内外压不平衡而伤及中耳腔所产生的各种症候群疾病,常表现为耳内堵塞感、耳鸣、耳痛、听力下降、眩晕等,可发生在飞行、潜水作业、低压舱环境、高压氧治疗甚至感冒时¨J。传统治疗主要有药物治疗、咽鼓管吹张、鼓膜穿刺抽液、鼓膜置管等。这些治疗有的是有创治疗,痛苦大;有的不良...