两种腺样体切除术对分泌性中耳炎伴腺样体肥大患儿的疗效对比

摘要/Abstract

摘要： 目的对比低温等离子腺样体切除术和电动吸切钻腺样体切除术对分泌性中耳炎伴腺样体肥大患儿的疗效。方法选取自2021年1月至2022年5月笔者所在医院收治的分泌性中耳炎伴腺样体肥大患儿70例作为研究对象，随机分为对照组和观察组各35例。对照组采用电动吸切钻腺样体切除术+置管术，观察组采用低温等离子腺样体切除术+置管术。观察两组患儿治疗效果、手术前后听力水平、手术时间、术后疼痛评分、术中出血量、不良事件发生率和血清炎症因子表达情况。结果经过治疗，对照组患儿总有效率为71.4%(25/35),显著低于观察组97.1%(34/35),差异有统计学意义(P<0.05)。两组患儿治疗后气导水平和气骨导差均显著低于治疗前，但两组治疗后两项听力指标相比，差异无统计学意义(P>0.05)。观察组患儿手术时间、术后12 h疼痛评分以及术中出血量均显著少于对照组，差异具有统计学意义(P<0.05);对照组不良事件发生率为28.6%(10/35),显著高于观察组5.7%(2/35),差异有统计学意义(P<0.05)。观察组患儿治疗后1个月、6个月时血清白细胞介素-1β和肿瘤坏死因子α显著低于对照组，差异有统计学意义(P<0.05)。结论低温等离子腺样体切除术联合置管术与电动吸切钻腺样体切除术联合置管术相比，具有更好的疗效，减少手术时间、术中出血量和术后12 h疼痛评分，降低不良事件发生率和治疗后1、6个月时血清白细胞介素-1β和肿瘤坏死因子α的表达水平，但对听力的改善无特殊作用。

关键词: 分泌性中耳炎, 低温等离子腺样体切除术, 电动吸切钻腺样体切除术, 腺样体肥大且迁延不愈, 置管术, 儿童

Abstract: ObjectiveTo investigate the efficacy of low temperature plasma adenoidectomy with that of electric aspiration adenoidectomy in the treatment of secretory otitis media in children with adenoid hypertrophy.MethodsFrom January 2021 to May 2022，70 children with secretory otitis media complicating adenoid hypertrophy were enrolled in our hospital.The randomized number table method was used to randomly divide them into two groups,with 35 in each. Group A(control group) received electric aspiration adenoidectomy + catheterization，while group B(observation group) received low temperature plasma adenoidectomy + catheterization）.Observe the treatment effect，hearing intensity before and after surgery，operation time，postoperative pain score,intra-operative bloodloss,incidence of adverse events and expression of serum inflammatory factors were observed.ResultsAfter treatment，the effective rate of group A was 71.4%，which was significantly lower than that of group B(97.1%) and the difference was statistically significant（P＜0.05）.The air conduction level and the bone conduction were significantly lower in the two groups after treatment，but the difference between the two groups was not statistically significant（P＞0.05）.The operation time，the pain score at 12h after operation and the intraoperative blood loss were significantly lower in group B than in group A，the difference being statistically significant（P＜0.05）.The incidence of adverse events in group A was 28.6%(10/35), significantly higher than that in group B(5.7%,2/35),and the difference was statistically significant（P＜0.05）.Serum IL-1β and TNF-α were significantly lower in group B than in group A at 1 month and 6 months after treatment（P＜0.05）.ConclusionLow-temperature plasma adenoidectomy combined with catheterization,compared with electric aspiration adenoidectomy, has a better effect，reducing the operation time，intraoperative blood loss and postoperative 12h pain score.The incidence of adverse events and the levels of serum IL-1β and TNF-α at 1 month and 6 months after treatment are reduced，but it has no particular effect on hearing improvement.

Key words:

Secretory otitis media；Low temperature plasma adenoidectomy, Electric aspiration adenoidectomy, Adenoid hypertrophy being prolonged unhealed, Catheterization, Children

王鑫, 刘志建, 刘慧颖, 孙姝阳, . 两种腺样体切除术对分泌性中耳炎伴腺样体肥大患儿的疗效对比[J]. 中国中西医结合儿科学, 2022, 14(6): 525-528.

WANG Xin, LIU Zhijian, LIU Huiying, SUN Shuyang. . Comparison of the effects of two types of adenoidectomy on children with secretory otitis media complicating adenoid hypertrophy[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2022, 14(6): 525-528.

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两种腺样体切除术对分泌性中耳炎伴腺样体肥大患儿的疗效对比

Comparison of the effects of two types of adenoidectomy on children with secretory otitis media complicating adenoid hypertrophy

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