听力学及言语疾病杂志
聽力學及言語疾病雜誌
은역학급언어질병잡지
JOURNAL OF AUDIOLOGY AND SPEECH PATHOLOGY
2014年
1期
56-59
,共4页
冯晓华%龙孝斌%汪建%陈勇挺%付晓燕%陈国强
馮曉華%龍孝斌%汪建%陳勇挺%付曉燕%陳國彊
풍효화%룡효빈%왕건%진용정%부효연%진국강
分泌性中耳炎%难治性%鼓膜通气管%穿孔%危险因素
分泌性中耳炎%難治性%鼓膜通氣管%穿孔%危險因素
분비성중이염%난치성%고막통기관%천공%위험인소
Secretory otitis media%Refractory%Ventilation tube%Perforation%Risk factors
目的:探讨鼓膜通气管治疗难治性分泌性中耳炎后,患侧鼓膜永久性穿孔的危险因素。方法回顾性分析1998年6月~2013年3月收治的病程超过2年的121例(210耳)难治性分泌性中耳炎患者的临床资料,其中穿孔组58例(105耳),对照组(未穿孔组)63例(105耳)。所有患者均使用Goode-T型或Shepard哑铃型通气管行鼓膜置管治疗,分析可能影响患侧鼓膜永久性穿孔的因素,包括性别、年龄、病程、通气管类型、置管史、置管次数、鼓膜表象、置管位置、中耳腔积液性质、是否行腺样体切除术及拔管时间等。结果单因素分析显示,穿孔组Goode-T型通气管、有置管史、置管次数(3次以上)、中耳腔粘液性积液分别占58.4%、57.3%、66.7%和57.9%,且均高于对照组(均为 P<0.01)。Logistic回归分析提示无论采用何种通气管,置管次数增多则患侧鼓膜永久性穿孔的风险增加,采用Goode-T型管较Shepard哑铃型管鼓膜发生穿孔的危险性增加1.637倍(OR=1.637,P<0.01)。结论难治性分泌性中耳炎患者鼓膜置管术后,使用Goode-T型通气管、有置管史、置管次数(3次以上)和中耳腔积液为黏液性四因素为鼓膜永久性穿孔的危险因素。
目的:探討鼓膜通氣管治療難治性分泌性中耳炎後,患側鼓膜永久性穿孔的危險因素。方法迴顧性分析1998年6月~2013年3月收治的病程超過2年的121例(210耳)難治性分泌性中耳炎患者的臨床資料,其中穿孔組58例(105耳),對照組(未穿孔組)63例(105耳)。所有患者均使用Goode-T型或Shepard啞鈴型通氣管行鼓膜置管治療,分析可能影響患側鼓膜永久性穿孔的因素,包括性彆、年齡、病程、通氣管類型、置管史、置管次數、鼓膜錶象、置管位置、中耳腔積液性質、是否行腺樣體切除術及拔管時間等。結果單因素分析顯示,穿孔組Goode-T型通氣管、有置管史、置管次數(3次以上)、中耳腔粘液性積液分彆佔58.4%、57.3%、66.7%和57.9%,且均高于對照組(均為 P<0.01)。Logistic迴歸分析提示無論採用何種通氣管,置管次數增多則患側鼓膜永久性穿孔的風險增加,採用Goode-T型管較Shepard啞鈴型管鼓膜髮生穿孔的危險性增加1.637倍(OR=1.637,P<0.01)。結論難治性分泌性中耳炎患者鼓膜置管術後,使用Goode-T型通氣管、有置管史、置管次數(3次以上)和中耳腔積液為黏液性四因素為鼓膜永久性穿孔的危險因素。
목적:탐토고막통기관치료난치성분비성중이염후,환측고막영구성천공적위험인소。방법회고성분석1998년6월~2013년3월수치적병정초과2년적121례(210이)난치성분비성중이염환자적림상자료,기중천공조58례(105이),대조조(미천공조)63례(105이)。소유환자균사용Goode-T형혹Shepard아령형통기관행고막치관치료,분석가능영향환측고막영구성천공적인소,포괄성별、년령、병정、통기관류형、치관사、치관차수、고막표상、치관위치、중이강적액성질、시부행선양체절제술급발관시간등。결과단인소분석현시,천공조Goode-T형통기관、유치관사、치관차수(3차이상)、중이강점액성적액분별점58.4%、57.3%、66.7%화57.9%,차균고우대조조(균위 P<0.01)。Logistic회귀분석제시무론채용하충통기관,치관차수증다칙환측고막영구성천공적풍험증가,채용Goode-T형관교Shepard아령형관고막발생천공적위험성증가1.637배(OR=1.637,P<0.01)。결론난치성분비성중이염환자고막치관술후,사용Goode-T형통기관、유치관사、치관차수(3차이상)화중이강적액위점액성사인소위고막영구성천공적위험인소。
Objective To explore the treatment using two different ventilation tubes insertion for secretory o-titis media ,and to determine which factors are associated with the tympanic membrane perforation after a extrusion or surgical removal of a ventilation tube(VT) .Methods A retrospective analysis of 121 cases (210 ears) with re-fractory secretory otitis media from 1998 June to 2013 March was carried out .There were 58 cases (105 ears ) and 63 cases (105 ears) in patients and control group ,respectively .All subjects had more than 2 years of history ,and were treated by two types of ventilation tube (Goode -T and Shepard tube) .Various factors were analyzed to deter-mine the factors associated with persistence of a tympanic membrane perforation after VT extrusion or removal ,in-cluding gender ,age ,medical history ,ventilation tube pattern ,location ,history of previous VT insertions ,intuba-tion period reason for VT insertion ,condition of the TM ,nature of the tympanic cavity effusion and previous ade-noidectomy ,et .Results Analysis factors of perforation group (105 ears) and the control group (without perfora-tion ,105 ears) ,were statistically significant in ventilation tube pattern (χ2 =6 .916 ,P<0 .01) ,history of previous VT insertions(χ2 =7 .325 ,P<0 .01) ,frequency of previous VT insertions (χ2 =13 .01 ,P<0 .01)and the nature of the tympanic cavity effusion(χ2 =7 .04 ,P<0 .01) .The proportion of perforation group about Goode - T ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were 58 .4% ,57 .3% ,66 .7% and 57 .9% respectively ,others had no significant difference between the two groups . The multivariate analysis showed that ,regardless of the ventilation tube ,the frequency of tube was the tympanic membrane perforation risk factor ;Goode-T tube increased the risk of perforation of tympanic membrane was 1 .637 times than Shepard tube(OR=1 .637 ,P<0 .01) .Conclusion Using the Goode - T type ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were four risk factors for persistence of a tympanic membrane perforation after VT insertion for secretory otitis media .