中国耳鼻咽喉头颈外科
中國耳鼻嚥喉頭頸外科
중국이비인후두경외과
CHINESE ARCHIVER OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY
2015年
8期
411-413
,共3页
杨柳%孙文锴%蔡蕾%田滢
楊柳%孫文鍇%蔡蕾%田瀅
양류%손문개%채뢰%전형
儿童%中耳炎,伴渗出液%咽鼓管%腺样体肥大
兒童%中耳炎,伴滲齣液%嚥鼓管%腺樣體肥大
인동%중이염,반삼출액%인고관%선양체비대
Child%Otitis Media with Effusion%Eustachian Tube%adenoid hypertrophy
目的观察腺样体肥大儿童的腺样体与咽鼓管圆枕的毗邻关系，探讨其与分泌性中耳炎的相关性。方法144例腺样体肥大（或同时扁桃体肥大）70°鼻内镜下行等离子消融术患儿，术中观察并记录腺样体与咽鼓管圆枕的毗邻关系，并将其分为Ⅰ、Ⅱ、Ⅲ共3型；比较3组患儿分泌性中耳炎发病率、腺样体重度肥大（A/N比值是否大于0.7）的发生率并计算有无统计学差异。结果本组患儿分泌性中耳炎发病率23.6%；腺样体与咽鼓管圆枕的毗邻关系及合并分泌性中耳炎，Ⅰ型3例（9.1%，3/33）、Ⅱ型10例（16.9%，10/59）、Ⅲ型21例（40.4%，21/52），Ⅰ型与Ⅱ型分泌性中耳炎发生率无显著性差异（χ2=1.077，P=0.299），Ⅰ型与Ⅲ型有显著性差异（χ2=9.757，P=0.002），Ⅱ型与Ⅲ型有显著性差异（χ2 =7.542，P=0.006）；Ⅰ型和Ⅱ型组腺样体A/N＞0.7之和为34.9%，三型组A/N＞0.7为82.2%，Ⅰ型及Ⅱ型腺样体重度肥大率之和与Ⅲ型有显著性差异（χ2=30.556，P=0.000）。结论腺样体与咽鼓管圆枕毗邻关系及腺样体的肥大程度与分泌性中耳炎有显著相关性。
目的觀察腺樣體肥大兒童的腺樣體與嚥鼓管圓枕的毗鄰關繫，探討其與分泌性中耳炎的相關性。方法144例腺樣體肥大（或同時扁桃體肥大）70°鼻內鏡下行等離子消融術患兒，術中觀察併記錄腺樣體與嚥鼓管圓枕的毗鄰關繫，併將其分為Ⅰ、Ⅱ、Ⅲ共3型；比較3組患兒分泌性中耳炎髮病率、腺樣體重度肥大（A/N比值是否大于0.7）的髮生率併計算有無統計學差異。結果本組患兒分泌性中耳炎髮病率23.6%；腺樣體與嚥鼓管圓枕的毗鄰關繫及閤併分泌性中耳炎，Ⅰ型3例（9.1%，3/33）、Ⅱ型10例（16.9%，10/59）、Ⅲ型21例（40.4%，21/52），Ⅰ型與Ⅱ型分泌性中耳炎髮生率無顯著性差異（χ2=1.077，P=0.299），Ⅰ型與Ⅲ型有顯著性差異（χ2=9.757，P=0.002），Ⅱ型與Ⅲ型有顯著性差異（χ2 =7.542，P=0.006）；Ⅰ型和Ⅱ型組腺樣體A/N＞0.7之和為34.9%，三型組A/N＞0.7為82.2%，Ⅰ型及Ⅱ型腺樣體重度肥大率之和與Ⅲ型有顯著性差異（χ2=30.556，P=0.000）。結論腺樣體與嚥鼓管圓枕毗鄰關繫及腺樣體的肥大程度與分泌性中耳炎有顯著相關性。
목적관찰선양체비대인동적선양체여인고관원침적비린관계，탐토기여분비성중이염적상관성。방법144례선양체비대（혹동시편도체비대）70°비내경하행등리자소융술환인，술중관찰병기록선양체여인고관원침적비린관계，병장기분위Ⅰ、Ⅱ、Ⅲ공3형；비교3조환인분비성중이염발병솔、선양체중도비대（A/N비치시부대우0.7）적발생솔병계산유무통계학차이。결과본조환인분비성중이염발병솔23.6%；선양체여인고관원침적비린관계급합병분비성중이염，Ⅰ형3례（9.1%，3/33）、Ⅱ형10례（16.9%，10/59）、Ⅲ형21례（40.4%，21/52），Ⅰ형여Ⅱ형분비성중이염발생솔무현저성차이（χ2=1.077，P=0.299），Ⅰ형여Ⅲ형유현저성차이（χ2=9.757，P=0.002），Ⅱ형여Ⅲ형유현저성차이（χ2 =7.542，P=0.006）；Ⅰ형화Ⅱ형조선양체A/N＞0.7지화위34.9%，삼형조A/N＞0.7위82.2%，Ⅰ형급Ⅱ형선양체중도비대솔지화여Ⅲ형유현저성차이（χ2=30.556，P=0.000）。결론선양체여인고관원침비린관계급선양체적비대정도여분비성중이염유현저상관성。
OB J ECT I V E To explore the adjacentpatterns between adenoid and Eustachian cushion in hypertrophic adenoid children and to study its relationship with otitis media with effusion(OME). METHODS A retrospective analysis was conducted in 144 cases of pediatric adenoidal hypertrophy(or concurrenttonsil hypertrophy) admitted for adenoid ablation under the 700 nasal endoscope. Children were divided into 3 groups(TypeⅠ, Ⅱ and Ⅲ) according to adjacentpatterns between adenoid and Eustachian cushion.The incidence of OME, severe hypertrophy of adenoid(A/N>0.7) in differentgroup were analyzed. RESULTS There were 34 children (23.6%) with OME, 3 (9.1%) in type Ⅰ, 10(16.9%) in type Ⅱ and 21(40.4%) in type Ⅲ. No significantdifference was existed between the incidence of OME in type Ⅰ and Ⅱ. In contrast, significantdifference were found in the incidence of OME between the type Ⅲ and type Ⅰ, Ⅱ. The incidence of severe adenoid hypertrophy was 34.9% in typeⅠandⅡ children and 82.2% in type Ⅲ children(P<0.05). CONCLUSION Adjacentpatterns between adenoid and Eustachian cushion, the degree of adenoid hypertrophy play an importantrole in the incidence of OME.
