鼓膜置管治疗难治性分泌性中耳炎鼓膜穿孔危险因素分析

Factors Affecting Tympanic Membrane Perforation in Refractory Secretory Otitis Media after the Extubation of Ventilation Tube

冯晓华;龙孝斌;汪建;陈勇挺;付晓燕;陈国强;

1:广州军区广州总医院耳鼻咽喉科

2:南方医科大学珠江医院耳鼻咽喉头颈外科

摘要
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。
关键词
分泌性中耳炎;难治性;鼓膜通气管;穿孔;危险因素
基金项目(Foundation):
作者
冯晓华;龙孝斌;汪建;陈勇挺;付晓燕;陈国强;
参考文献

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