目的 探讨低温等离子刀行腺样体消融并单纯鼓膜切开不行鼓膜置管和行鼓膜置管2种方法对治疗儿童分泌性中耳炎伴腺样体肥大的疗效.方法 分析56例分泌性中耳炎伴腺样体肥大患儿的临床资料,术前均常规行鼻内镜及声导抗检查明确诊断;分别行低温等离子刀手术切除腺样体并行鼓膜切开不置管(A组)与并行鼓膜切开加置管(B组),术后观察统计2种方法治疗分泌性中耳炎的疗效.结果 A组28例,治愈18例,有效7例,无效3例,有效率89.3%.B组28例,治愈20例,有效6例,无效2例,有效率92.9%.2组疗效相比无统计学差异.A组发生并发症12例,B组发生5例,两组比较有统计学差异.结论 对于分泌性中耳炎伴腺样体肥大,腺样体切除术同时行鼓膜切开或鼓膜置管术均是有效的治疗方法,但鼓膜置管术术后并发症少,值得推广.%Objective To explore the clinical effect of low temperature plasma ablating adenoidectomy with myringotomy or grommet insertion on children with secretory otitis media. Methods Diagnosis is confirmed through nasal endoscope and acoustic immittance measurement. Fifty-six cases of secretory otitis media with adenoid hypertrophy were treated which was divided as group A (adenoidectomy with myringotomy) and group B (adenoidectomy with grommet insertion). Results Among 28 cases in group A, 18 cases were cured, 7 cases were improved, 3 cases were inefficient and the effectiveness rate was 89.3%. Among 28 cases in group B, 20 cases were cured, 6 cases were improved, 2 cases were inefficient and the effectiveness rate was 92.9%. There was no significant difference in effective rate between the two groups. The postoperative complication rate of group B was significantly lower than that of group A (P<0.05). Conclusion The clinical effect of grommet insertion under ear endoscopy combined with adenoidectomy treatment is good, which is a safe and reliable choice for the treatment of secretory otitis media.
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