血管内支架成形术治疗颈动脉狭窄产生持续性低血压的危险因素研究

目的研究讨论血管内支架成形术治疗颈动脉狭窄产生持续性低血压的危险因素。方法我科从2011年6月至2012年10月间血管内支架成形术治疗颈动脉狭窄40例,分析支架成形术后产生持续性低血压危险因素的原因。结果在40例的患者中,有28例患者颈动脉狭窄超过70%,28例中术后产生持续性低血压有23例;12例患者狭窄低于70%,术后产生持续性低血压3例,术前有颈动脉狭窄大于70%患者术后产生持续性血压的比例明显高于狭窄低于70%患者(P<0.05)。结论若患者术前有低血压病史,术中操作不当时间过长,尤其是颈动脉狭窄程度严重,选取的支架直径大于颈动脉直径,术后则较普通患者容易发生持续性低血压。     

冠脉介入术后低血压情况分析

目的:通过分析冠状动脉支架置人术术中及术后低血压的发生率及相关因素,达到预测危险因素减少并发症的目的.方法:回顾性分析48例冠状动脉中到重度狭窄行支架置入术患者术中、术后发生低血压的情况,以明确其与临床特点、操作过程及影像的关系;低血压的发生情况采用单变量分析.结果:48例患者均成功置入冠状动脉支架,术中、术后均发生低血压;预测冠脉造影及支架置入术后低血压的因素包括斑块性质、狭窄位置,尤其是合并颈动脉狭窄或闭塞是独立的危险因素.结论:冠脉造影支架置入术中和术后发生低血压是很常见的现象;这种低血压具有一定的危险性,绝大多数的低血压可以通过药物治疗缓解;并发症的发生可以通过其临床和影像特点有一定的预见性.     

非顺应性高压球囊在冠脉中重度钙化病变介入治疗中的应用

目的研究比较非顺应高压球囊与普通球囊在中重度冠脉钙化病变介入治疗中作用。方法收集2005～2006年间普通球囊预处理中重度冠脉钙化病变35例与2007～2008年间非顺应高压球囊预处理中重度冠脉搏钙化病变32例．两组的性别、年龄、危险因素基本一致,前者用普通球囊预处理,球囊商径参照病变血管直径．通常为2．0～2．5mm,长度不超过病变范围,压力常为8-14atm。后者用非顺应性高压球囊压力滴定（压力以2atm渐增）序贯预处理,球囊直径参照病变血管直径,通常为3．0mm,长度为10～15mm．压力为8-14atm：如大直径球囊不能通过,可先用小球囊预扩。预扩的终止标准以充分预扩张、支架能顺利通过为准。两组支架置入后根据情况再行高压后扩张。结果非顺应性高压球囊预处理组手术成功率高于普通球囊预处理组（97％vs 83％,P〈0．05）,而且残余狭窄、并发症（球囊破裂、冠脉夹层、无复流）较普通组也有降低趋势。结论我们认为对冠脉中重度钙化病变预处理时．如果没有旋磨装置．应用非顺应性高压球囊预处理．可以提高手术成功率．增加手术安全性。     

经皮冠状动脉内成形术与冠状动脉支架术的临床应用

目的　评价冠状动脉内成形术 (PTCA)和支架置入术的临床疗效。方法　总结 1996年 11月至 2 0 0 2年 12月行PTCA和支架置入术的冠心病患者 3 96例。结果　 3 96例冠心病患者 478支冠状动脉血管PTCA并支架置入 42 5枚 ,置入成功率 98.6% ,无明显并发症发生。支架平均直径 ( 3 .0 5± 0 .42 )mm ,平均长度 ( 18.48± 6.42 )mm ,释放支架时球囊所加压力平均 ( 12 .65± 3 .0 8)atm。结论　PTCA和支架置入术是一种安全、有效的介入性治疗技术 ,其成功率高 ,并发症少。     

腔内球囊扩张内支架管置入治疗输尿管狭窄26例报告

目的探讨腔内球囊扩张内支架管置入对输尿管狭窄的治疗效果。方法26例经静脉尿路造影（IVP）或逆行造影确诊的输尿管狭窄病人，用球囊导管扩张，双J管及内支架管置入，30—60d拔除双J管。结果26例行IVP检查见狭窄段明显扩张，肾积水明显减轻。其中2例术后6月再狭窄，1例术后11月再狭窄，再次行球囊扩张及永久性网状金属内支架管置入后随访半年未见再狭窄。结论腔内球囊扩张术治疗输尿管狭窄操作简单，而置入内支架管能明显提高疗效。     

经皮冠状动脉介入相关心肌损伤的危险因素分析

目的 探讨经皮冠状动脉介入(PCI)相关心肌损伤的危险因素。方法 146例冠心病患者行冠脉造影+经皮冠脉支架植入术,依据术后24 h内心肌肌钙蛋白I(cTnI)最大值分为三组,第一组(18例):PCI术后cTnI在正常范围内(cTnI<0.04 μg·L-1)组;第二组(44例):正常上限≤cTnI<正常上限5倍(0.04 μg·L-1≤cTnI<0.2 μg·L-1);第三组(84例):cTnI≥正常上限的5倍(cTnI≥0.2μg·L-1);通过分析患者临床基础特点及血清学指标检测、冠脉病变及手术过程等因素,分析PCI围术期心肌损伤的危险因素。结果 (1)三组患者的年龄、性别、既往PCI术史、高血压病史、糖尿病史、吸烟史、他汀类药物服用史以及高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白B(apo-B)、左室射血分数(LVEF)等指标上差异无统计学意义,但术前超敏C反应蛋白(hs-CRP)差异有统计学意义,且随着术前数值的升高,术后cTnI数值越高;(2)术中参数提示:支架总长度[(44.78±15.57) vs(44.64±23.73) vs(58.43±27.66) mm,P=0.006]、最大支架直径[(3.31±0.51) vs(3.35±0.43) vs(3.15±0.44) mm,P=0.039]、球囊个数[(2.00±1.09) vs(2.27±1.44) vs(3.10±1.47)个,P=0.001]、支架平均释放压力[(8.22±1.48) vs(9.91±1.79) vs(12.40±1.53) atm,P<0.001]以及单支病变比例(55.6% vs 27.3% vs 19.0%,P=0.006)在三组比较差异有统计学意义,单支病变在第一组中比例最高,第三组中比例最低;随着术中支架长度的增加,支架平均释放压力的增大以及球囊使用的增多,术后cTnI数值越高;(3)依据PCI术后cTnI是否超过5倍正常上限水平,将患者分为两组,通过Logistic回归分析,结果提示hs-CRP(OR 9.359,5% CI:3.589,4.402,P<0.001)、支架总长度 (OR 1.043,5% CI:1.009,1.078,P=0.012) 以及支架平均释放压力(OR 4.124,5% CI:2.024,8.403,P<0.001)是PCI围术期心肌损伤的危险因素。结论 hs-CRP、支架总长度以及支架平均释放压力是PCI围术期心肌损伤的危险因素,若能通过术前检测患者的基础临床特点尤其是hs-CRP,以及术中注意调控操作参数,有望预测并减少PCI围术期心肌损伤的发生率。     

动脉支架成形术治疗颈动脉粥样硬化性狭窄

目的：分析颈动脉支架成行术治疗颈动脉粥样硬化性狭窄的效果。方法：15例症状性颈动脉狭窄患者,在血栓保护伞保护下,置入颈动脉支架,并以球囊扩张狭窄部位。结果：所有患者成功置入支架,术后出现同侧脑梗塞1例,穿刺点皮下血肿3例,颈动脉夹层1例,血管痉挛2例,分别通过手术或药物治愈。随访3～15月,TIA减少3例,对侧脑梗塞1例,其余患者TIA消失,语言及肢体活动改善。结论：血管内支架成行术治疗颈内动脉粥样硬化性狭窄．配合血栓保护伞使用,操作安全．效果明显,值得临床应用。     

急诊经皮冠状动脉腔内成型术加冠脉支架置入术治疗老年急性心肌梗死的疗效与安全性评价

目的：观察急诊经皮冠状动脉腔内成型术加冠脉内支架置入术治疗老年急性心肌梗死的临床疗效和安全性。方法：对5例发病时间在2－6．5小时内，年龄＞70岁的急性心肌梗死患者作冠脉造影，确定梗死相关血管。在OEC9800下给予2．0－2．5mm直径球囊6－8atm预扩张后置入支架6枚。结果：5例患者支架置入均获成功。TIMI血流均达3级，无残余狭窄，无严重并发症。住院期间无再梗、心绞痛及死亡发生。结论：老年急性心肌梗死行急诊经皮冠状动脉腔内成型术加支架置入术临床疗效佳，是较好的抢救治疗手段。     

内镜下扩张治疗食管癌术后吻合口良性狭窄的疗效分析

目的 探讨内镜下扩张治疗用于食管癌术后吻合口狭窄的临床疗效.方法 将213例食管癌术后吻合口狭窄患者随机分为4组,分别行探条扩张、球囊扩张、探条扩张＋暂时性支架置入及球囊扩张＋暂时性支架置入治疗,术后观察患者临床症状缓解情况.结果 4组总有效率分别为81.6％、80.4％、95.0％、96.2％,探条组与球囊组总有效率差异无统计学意义（P＞0.05）;置入暂时性支架组总有效率高于单纯探条或球囊组,差异有统计学意义（P＜0.05）;置入暂时性支架组平均扩张（1.48±0.86）次,单纯探条或球囊组平均扩张（2.26±1.37）次,前者扩张次数明显低于后者,差异有统计学意义（P＜0.01）;支架组与无支架组术后并发症发生率的差异无统计学意义（P＞0.05）.结论 内镜下置入暂时性食管支架相对于单纯性探条或球囊扩张治疗食管癌术后良性狭窄,疗效显著,平均扩张次数少,并发症少,能明显改善患者的临床症状。     

冠心病介入治疗的临床应用分析

目的 分析冠心病介入治疗的临床价值。方法 从1998年2月－2000年7月,共有30例患（男18例,女12例）,造影显示冠状动脉狭窄程度均≥50％,2例单纯行球囊扩张术,28例行冠脉支架术。结果 42枚支架植入28例患中,支架全部置入成功,1例左主干病变直接支架置入成功。44支相关冠脉再通成功,成功率84．69％。术后冠脉造影显示管腔扩张满意。随访1－28个月,心绞痛症状较术前明显减轻或消失,未发生并发症,1例术后3月发生猝死。结论 由于支架的应用,扩大了PTCA的适应症,减少了PTCA的并发症。选择性左主干病变直接置入支架,安全,有效,可行。     

INOUE球囊经皮肺动脉瓣成形术治疗肺动脉瓣狭窄(附18例报告)

目的总结用INOUE球囊经皮肺动脉瓣成形术(percutaneousballoonpulmonaryvalvuloplasty,PBPV)治疗肺动脉瓣狭窄18例患者的经验。方法肺动脉瓣狭窄患者18例,采用介入和超声多普勒评价经皮球囊肺动脉瓣成形术的疗效。结果18例PBPV患者术后即刻右心室收缩压由(101.4±28.2)mmHg降至(48.5±16.7)mmHg(P<0.01),右房压由(16.9±7.5)mmHg降至(9.8±4.3)mmHg(P<0.05),肺动脉压由(15.2±3.1)mmHg升至(23.1±5.6)mmHg(P<0.05),肺动脉与右心室跨瓣压差(ΔP)由(76.5±25.1)mmHg降至(21.7±12.2)mmHg(P<0.01)。多普勒随访结果术后3个月跨瓣压差与术后即刻比较,差异有显著性(P<0.05)。结论经皮球囊肺动脉瓣成形术治疗肺动脉瓣狭窄安全有效。     

兔颈总动脉破裂粥样硬化斑块模型的建立

目的建立负压吸引激发兔颈总动脉粥样硬化斑块破裂,建立破裂斑块模型。方法将30只健康雄性新西兰白兔随机分为3组,分别为对照组（n=10）、高脂饲养组（n=10）和球囊损伤＋高脂饲养组（n=10）。饲养8周后,彩色多普勒超声测量颈总动脉内径、内-中膜厚度（IMT）及颈动脉血流速度等,评估动脉IMT与动脉粥样硬化程度的关系。采用＂腔外负压＂法诱导斑块破裂并处死动物,观察诱发斑块破裂成功率,在肉眼及光镜下观察颈动脉内膜形态特征。结果球囊损伤＋高脂饲养组、高脂饲养组的颈总动脉血流速度显著快于对照组,IMT显著厚于对照组,颈总动脉内径显著短于对照组;球囊损伤＋高脂饲养组的颈总动脉内径显著短于高脂饲养组,IMT显著厚于高脂饲养组,颈总动脉血流速度显著快于高脂饲养组（P〈0.05）。球囊损伤＋高脂饲养组可见平滑肌细胞增生,脂质、炎症细胞、泡沫细胞浸润,符合不稳定性斑块特征,有8例诱发斑块破裂,1例死亡;高脂饲养组可见内膜下脂质沉积,炎症细胞浸润,但内皮细胞完整,内弹力板排列整齐,1例诱发斑块破裂,无动物死亡;对照组内皮细胞完整,中层平滑肌细胞排列整齐,无一例诱发斑块破裂,无动物死亡。结论本实验建立动脉粥样硬化斑块破裂模型成功率高,动物死亡率低,实验操作简便易行,为冠心病的生理、病理及药物学效应方面研究提供了可靠的实验平台。     

Lower oesophageal sphincter pressure and timed barium oesophagogram: two objective parameters in the non-invasive assessment of primary achalasia

BACKGROUND: The non-invasive assessment of primary achalasia is not precise. AIM: To compare investigations before and 1 month after balloon dilation in achalasia. METHODS: Fifty-two patients with primary achalasia were enrolled. Subjective and objective variables of oesophageal functions were analysed before and 1 month after balloon dilation. RESULTS: The mean predilation symptom score, lower oesophageal sphincter pressure, height and volume of barium at 5 min were 7.7 +/- 2.6, 62.0 +/- 25.1 mmHg, 9.2 +/- 6.1 cm and 53.2 +/- 49.8 mL respectively; the mean postdilation values were 3.0 +/- 3.0, 34.1 +/- 12.5 mmHg, 7.9 +/- 5.1 cm and 28.0 +/- 30.1 mL respectively. The before dilation volume of barium at 5 min correlates significantly with lower oesophageal sphincter pressure (P < 0.01). The mean symptom scores, lower oesophageal sphincter pressure and volume of barium at 5 min dropped significantly after intervention (P < 0.01), but the reduction in barium height at 5 min was not significant. The percentage changes in volume at 5 min significantly predicted the percentage changes in lower oesophageal sphincter pressure (P < 0.01). CONCLUSIONS: The volume of barium retention at 5 min can predict the lower oesophageal sphincter pressure before and after balloon dilation in primary achalasia. This could be used as a non-invasive objective tool for initial and post-dilation assessment.     

FACTORS INFLUENCING THE EFFECTS OF INTRAVENOUS NALOXONE ON ARTERIAL PRESSURE AND HEART RATE AFTER HAEMORRHAGE IN CONSCIOUS RABBITS

The circulatory responses to different intravenous doses of naloxone were studied in conscious rabbits before and after haemorrhage, under different conditions including prior ganglion blockade. Unless there had been blood loss, naloxone elicited no pressor response, even in high dose. After bleeding so that arterial pressure fell to 40 mmHg, the dose-response relationship for naloxone had two components. Over a low-dose range (threshold 0.3 mg/kg) naloxone had a modest pressor effect but did not affect heart rate. Over a much higher dose range (threshold 0.6 mg/kg) naloxone caused a marked rise in arterial pressure and a profound bradycardia. The highest dose of naloxone examined (25 mg/kg) caused a rise in arterial pressure of 70 mmHg and a reduction in heart rate of 160 beats/min. The pressor and bradycardic effects of naloxone were the same whether post-haemorrhagic hypotension lasted 5, 10, 20 or 30 min. The responses to naloxone in low or high dose depended much more closely on the volume of blood removed than on the level to which arterial pressure fell. Even after non-hypotensive haemorrhage a high dose of naloxone had marked pressor and bradycardic effects. Ganglion blockade prior to haemorrhage abolished the pressor response to a low, but not to a high, dose of naloxone. It was concluded that prolonged and severe hypotension are not necessary to 'prime' the cardiovascular system to respond to naloxone after haemorrhage. In a high dose its pressor effects appear to be mediated post-ganglionically, but in a low dose it may act within the central nervous system.     

住院老年患者体位性低血压发生率及相关危险因素初探

目的观察住院老年患者体位性低血压的发病情况及相关危险因素。方法以2009年7月～2011年12月间入住我科的60岁以上老年患者为研究对象,测定卧、立位血压(休息至少5min后的卧位,站立即刻,站立后3min的血压),并采集病史。结果共收集了112例患者的资料,平均年龄(78.23±16.53)岁,其中男42例,女70例。共有31例患者(27.68%)存在体位性低血压。这31例患者中,合并高血压、饮酒、肾功能衰竭、甲状腺功能减退的比率明显高于无体位性低血压患者,而年龄、性别、糖尿病、冠心病、脑卒中、癌症在体位性低血压与非体位性低血压组无显著差异。Logistic逐步回归分析发现高血压与饮酒患者发生体位性低血压的相对危险度(RR)分别为2.7(95%CI1.0～6.8,P=0.04)和3.3(95%CI0.98～9.47,P=0.02)。结论体位性低血压在住院老年患者中比较常见,高血压、饮酒是发生体位性低血压的相关危险因素。     

PCI球囊实际破裂压体外研究

目的观察不同厂家PCI球囊(简称球囊)在体外的实际破裂压(Real Rupture Pressure RRP),研究其与支架长度、直径、扩张时间、扩张次数及最大扩张压力等因素的相关性。方法将完成体内扩张的球囊在室温下以每秒增加4～6大气压的速度用以生理盐水1:1稀释的泛影葡胺将不同厂家PCI球囊在体外打破,记录球囊体外的RRP,观察不同PCI球囊之间RRP的差异,用多元线性回归分析球囊在体外RRP与支架长度、直径、扩张时间、扩张次数及体内最大扩张压力的相关性。结果所有的半顺应性非支架球囊均能耐受23个大气压以内的扩张而不发生破裂,半顺应性支架球囊均能耐受24个大气压以内的扩张而不发生破裂。半顺应性非支架囊组,平均RRP最高的是Sun组,最低为Sprinter组;支架囊组,Taxus组的平均RRP最高,Endeavor组最低。RRP变异最大的为Partner组,最小的为En-deavor组。非顺应性球囊均能耐受32个大气压以内的扩张。PCI球囊的体外RRP与支架外径明显相关,但与扩张次数、扩张时间、球囊长度及最大扩张压无明显相关性。结论研究提示在测试中所有品牌的PCI球囊均能安全耐受厂家推荐的扩张压力。各品牌球囊的RRP不同,但在体外均能耐受20个大气压以内的扩张,球囊直径对球囊的RRP具有最重要的影响。     

单纯性肥胖女性绝经前后血管内皮功能和胰岛素抵抗的变化

目的探讨单纯性肥胖女性绝经前后血管内皮功能和胰岛素抵抗的变化及其影响因素。方法单纯性肥胖女性197例分为绝经前组113例和绝经后组84例，测定两组血管内皮依赖性舒张功能（血流介导）和内皮非依赖性舒张功能（硝酸甘油介导），并测定体脂、血压、血糖、血脂和胰岛素抵抗指数（HOMA-IR）等指标进行对比分析。结果绝经后内皮依赖性舒张功能降低较绝经前更明显[分别为（5．7±5．2）％和（7．8±5、7）％，P〈0．05]，并且与腰臀比和血浆内皮素（ET-1）呈显著正相关（分别为r=0．325和r=0．228，均P〈0．05），与血清NO显著负相关（r=-0．263，P〈0．05）。2组HOMA-IR无统计学意义。结论绝经后肥胖女性血管内皮功能较绝经前显著降低；绝经前后胰岛素抵抗无变化。     

Anandamide and methanandamide induce both vanilloid VR1- and cannabinoid CB1 receptor-mediated changes in heart rate and blood pressure in anaesthetized rats

In anaesthetized rats activation of vanilloid receptors on sensory vagal nerves elicits rapid bradycardia and hypotension (Bezold-Jarisch reflex). Recent in vitro experiments revealed that the endogenous cannabinoid ligand anandamide acts as an agonist at the vanilloid VRI receptors. The present study was aimed at examining whether vanilloid VR1 receptors are involved in the cardiovascular effects of anandamide in the anaesthetized rat. Intravenous injection of anandamide, its stable analogue methanandamide and the vanilloid receptor agonist capsaicin produced a dose-dependent immediate and short-lasting decrease in heart rate and blood pressure with the following rank order of potencies: capsaicin > methanandamide > anandamide. This bradycardia was dose-dependently diminished by the selective vanilloid receptor antagonist capsazepine (0.3-3 micromol/kg) and the nonselective inhibitor of these receptors, ruthenium red (1-10 micromol/kg). Both antagonists reduced or tended to reduce the hypotension stimulated by the agonists. Following this bradycardia and hypotension (presumably evoked by the Bezold-Jarisch reflex; phase I), capsaicin, anandamide and methanandamide led to a brief vasopressor effect (phase II). Subsequently both anandamides, but not capsaicin, induced a more prolonged decrease in blood pressure (phase III). Capsazepine and ruthenium red (at doses up to 3 tmol/kg and 10 micromol/kg, respectively) failed to affect these changes in blood pressure. The cannabinoid CB1 receptor antagonist SR 141716 at 3 micromol/kg abolished the prolonged decrease in blood pressure (phase III) induced by anandamide and methanandamide, but had no effect on the reflex bradycardia and hypotension (phase I) and on the subsequent vasopressor effect (phase II) evoked by capsaicin, anandamide and methanandamide. In conclusion, the endogenous cannabinoid receptor agonist anandamide and its stable analogue methanandamide induce reflex bradycardia and hypotension (phase I) by activating the vanilloid VRI receptor. Whereas the mechanism underlying the brief vasopressor effect (phase II) is unknown, the prolonged hypotension (phase III) results from stimulation of the cannabinoid CB1 receptor.     

SD-3211, a novel benzothiazine calcium antagonist, alone and in combination with a beta-adrenoceptor antagonist, produces antihypertensive effects without affecting heart rate and atrioventricular conduction in conscious renal hypertensive dogs.

We compared the effects of SD-3211, a novel calcium antagonist, on blood pressure, heart rate, and atrioventricular conduction with those of diltiazem using conscious renal hypertensive dogs (one-kidney, one-clip type). We also examined the combined effects of these calcium antagonists with a beta-adrenoceptor antagonist, propranolol, on these variables. Oral administration of SD-3211 (1.25, 2.5, and 5 mg/kg) resulted in a dose-dependent decrease in blood pressure without affecting heart rate. SD-3211 at all three doses significantly decreased systolic blood pressure. At 2.5 and 5 mg/kg the compound elicited significant decreases in mean blood pressure and diastolic blood pressure. Hypotension obtained with the highest dose of SD-3211 lasted for at least 9 h. No significant alteration in PR interval was observed in electrocardiograms after administration of SD-3211. Diltiazem, given orally at doses of 2.5 and 5 mg/kg but not 1.25 mg/kg, produced significant hypotension with little change in heart rate. The duration of hypotension induced by the highest dose of diltiazem was only 3 h. Diltiazem prolonged PR interval in a dose-dependent manner, causing second-degree atrioventricular block in some dogs. Combined administration of SD-3211 or diltiazem (2.5 mg/kg) with propranolol (30 mg/kg) resulted in enhanced hypotension with no alteration in heart rate. SD-3211 plus propranolol had little effect on the PR interval, whereas diltiazem plus propranolol caused a markedly enhanced prolongation. These results indicate that SD-3211 is an antihypertensive agent with long-lasting action and little effect on heart rate and atrioventricular conduction and, when administered alone or in combination with propranolol, may be useful in the treatment of hypertension.     

咽鼓管球囊扩张术治疗症状性咽鼓管功能障碍的可行性分析

目的 分析症状性咽鼓管功能障碍患者采用咽鼓管球囊扩张术治疗的效果及可行性,旨在为该疾病的临床治疗提供有效参考.方法 症状性咽鼓管功能障碍患者50例(72耳),所有患者均合并耳闷,间或伴有耳鸣、耳痛及听觉模糊等症状,均拟行咽鼓管球囊扩张术进行治疗,术后通过随访观察患者的临床治疗效果,主要通过耳内镜检查结果、主观症状改善情况、纯听力检测、咽鼓管检测等指标进行评估.结果 本组50例患者的手术均行顺利完成,且未见严重的并发症.50例患者手术后1周与6个月时的耳闷、听觉模糊、耳痛及耳鸣等主观症状评分均显著低于手术前,差异有统计学意义(P＜0.05).鼓室压图检查显示,手术前C型图19耳(26.39％),手术后1周C型图11耳(15.28％),手术后6个月C型图3耳(4.17％),可见手术后1周、6个月时的C型图率显著降低,差异有统计学意义(P＜0.05).50例患者手术后1周、6个月时不同压力下的咽鼓管测压开放指数≤1出现率与咽鼓管评分均显著高于手术前,差异有统计学意义(P＜0.05).结论 对症状性咽鼓管功能障碍患者采用咽鼓管球囊扩张术进行治疗效果显著,可有效改善患者的咽鼓管功能,值得进一步推广.