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【目的】观察可视内窥镜下腺样体切除术联合鼓膜置管术治疗儿童分泌性中耳炎的临床疗效。【方法】对本院96例(152耳)分泌性中耳炎并腺样体肥大患儿行可视内镜下腺样体切除和鼓膜切开置管术,观察治疗后有无并发症发生及临床疗效等情况。【结果]96例(152耳)患儿治愈80例,有效15例,无效1例。无效的1例发生于拔除通气管鼓膜愈合后1个月,再次手术切除加置管而愈。所有患儿获随访6~12个月。无中耳感染、出血,纯音测听平均为21.5dBHL,听阈平均提高25dBHL。复查电子鼻咽镜:鼻咽部创面光滑、无残留,咽鼓管咽口及圆枕无损伤。【结论】可视内窥镜下腺样体切除联合鼓膜置管术治疗儿童分泌性中耳炎疗效显著,是一种治疗儿童分泌性中耳炎并腺样体肥大安全有效的方法。 相似文献
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本院于1997年5月至2001年12月分别采取腺样体切除术和药物保守法治疗儿童分泌性中耳炎58例,其疗效比较报道如下。 相似文献
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腺样体切除术治疗儿童分泌性中耳炎的系统评价 总被引:7,自引:0,他引:7
目的评价腺样体切除术(adenoidectomy,AT)治疗儿童分泌性中耳炎(otitis media with effusion,OME)的疗效及安全性.方法机检Medline(1966~2001)、EMbase(1974~2001)、Cochrane 临床对照试验资料库(CCTR)和中国生物医学文献数据库(CBM,1989~2001),手检5种国内耳鼻咽喉科杂志的有关文献,查阅合格文章的参考文献,筛选出符合纳入标准的AT治疗儿童OME的随机对照试验,至少由两位研究者独立评估试验质量和提取数据.应用RevMan 4.1软件进行统计学分析.结果共收集到相关文献248篇,共纳入文献13篇,1 430例病人(耳).这13篇文献总的方法学质量较高,全部来自欧、美国家.在AT与鼓膜切开术以及不治疗比较的试验中,未发现AT的疗效优于其他疗法.AT与鼓膜置管术比较的4个试验提示,鼓膜置管术的疗效优于AT.10篇文献描述了术后出血、鼻咽狭窄和腭咽功能不全等并发症.结论目前尚无证据表明AT治疗OME的疗效优于鼓膜切开术、鼓膜置管术和不治疗,也没有证据表明哪一种手术方式的疗效最佳,但是必须注意其术后并发症.对于药物治疗无效的OME患儿,如同时存在复发的多种危险因素,早期施行AT联合鼓膜置管术可能为最合理的治疗方法. 相似文献
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正儿童慢性鼻窦炎是儿童的常见病、多发病,其病因及治疗与成人有很大区别,临床研究[1]表明腺样体肥大是儿童慢性鼻窦炎的主要原因之一。本科2012年5月—2015年5月对62例儿童慢性鼻窦炎伴腺样体肥大的患儿行腺样体切除术,取得了满意效果,现报告如下。1资料与方法1.1一般资料选取本科2012年5月—2015年5月治疗的慢性鼻窦炎患儿116例,男68例,女48例,平均 相似文献
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刘芳 《中国现代临床医学》2004,3(6):8-8
目的探讨全麻鼻内镜下儿童腺样体切除术的利与弊。方法1999年5月~2004年1月,因腺样体肥大在我院接受手术治疗的患者76例,其中全麻下施行手术46例,表麻下施行手术30例。结果所有患者术后均取得了满意的通气效果。打鼾及中耳炎较术前明显改善,个别患儿术后仍有睡时打鼾症状。结论全麻鼻内镜下施行增殖体切除术能够使术者更加从容的施行手术,减轻患儿心理及身体上的痛苦。 相似文献
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腺样体肥大与分泌性中耳炎相关性分析 总被引:6,自引:0,他引:6
目的探讨腺样体大小与分泌性中耳炎(OME)的相关性及有效治疗方法。方法根据腺样体肥大的程度,将116例患儿分为腺样体中度肥大组和病理性肥大组,分析腺样体肥大程度对中耳功能的影响及两组间OME发病率的差异及切除腺样体对OME的疗效。根据接受手术与否,将鼓室声导抗图B型曲线患者分为两组,比较其治愈率。结果两组之间OME发生率差异有统计学意义,腺样体切除对OME的疗效优于单纯保守治疗组。结论腺样体肥大程度与OME发病率呈正相关。腺样体切除是治疗OME的重要方法。 相似文献
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<正>腺样体肥大是儿童常见病,是引起儿童分泌性中耳炎、儿童鼾症、鼻窦炎的主要病因。随着鼻内镜技术的应用及手术器械的发展,鼻内镜手术不再局限于 相似文献
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Otitis media with effusion (OME) is a common clinical condition that is associated with hearing loss. It can be diagnosed at least once in approximately 80% of preschool children: 30-40% of them have recurrent episodes, and 5-10% have chronic disease. OME, in recurrent and persistent cases, might significantly delay or impair communication skills, resulting in behavioral and educational difficulties. Several therapeutic approaches have been used to avoid these problems. Most, however, have not been adequately studied, and no definitive conclusions can be drawn. Official guidelines do not recommend the use of decongestants, antihistamines, steroids, or antibiotics. The data are too scanty to assess other interventions, although autoinflation, because it incurs neither cost nor adverse events, deserves attention. Surgical procedures (i.e., tympanostomy tube insertion and adenoidectomy as an adjuvant) can be useful in some cases. This review evaluates all the current OME treatments and preventive measures, including their possible adverse events. 相似文献
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INTRODUCTIONItisimportanttodiagnoseearlyandtreatproperlyforthechildrenpatientswithsecretoryotitismedia(SOM)becauseofthelanguage,educationandpsychologicaldysfunctionleadedbythehearinglossinthechildhood.MATERIALSANDMETHODSMaterials1995-10/2001-09themyringotomyandventilationtubeinsertionsurgerieswereperformedin56children,34boysand22girls,aged2years9monthsto15years.Unilateraloperationswereperformedin11cases.Theremainingcasesreceivedbilateraloperatio… 相似文献
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目的探讨同期鼻内镜下低温等离子行腺样体切除联合鼓室置管治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴分泌性中耳炎的疗效。方法对92例(132耳)儿童OSAHS伴分泌性中耳炎患者分为两组:A组52例(70耳),采用鼻内镜下腺样体切除联合鼓室置管治疗;B组40例(62耳)仅在鼻内镜下腺样体切除而不行鼓室置管。结果 A组有效率为94.29%;B组有效率为65.15%。两组比较差异有显著性(χ8=18.122,P<0.05)。A组术后中耳积液平均时间为(5.34±1.35)d。B组术后中耳积液平均时间为(16.63±5.57)d。两组比较差异有显著性(t值=16.408,P<0.05)。结论鼻内镜下低温等离子行腺样体切除联合鼓室置管治疗儿童OSAHS伴分泌性中耳炎,在保证OSAHS疗效的同时,又缩短了中耳积液时间,提高了听力。 相似文献
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目的:探讨耳内窥镜下经口鼻联合径路电动切削器行儿童腺样体切除术的可行性和优点。方法:采用电动切削器对42例腺样体肥大患儿行腺样体切除术。结果:随访0.6~2年,42例患儿鼻腔及鼻咽部光滑无粘连,无腺样体残留,咽鼓管圆枕及咽口无损伤及粘连。结论:耳内窥镜下经口鼻联合径路运用电动切削器行腺样体切除术能在直视下进行,且病变组织切除彻底,手术疗效良好,并发症少。 相似文献
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Steven M. Green MD Steven G. Rothrock MD Timothy P. Nesper MD Christopher B. Hummel MD 《Academic emergency medicine》1994,1(4):346-352
Objective : To assess the ability of ED tympanometry to identify those children with acute otitis media who are at greater risk for treatment failure, recurrent infection, or persistent middle ear effusion.
Methods : A prospective observational study was performed in the EDs of a county hospital and a university medical center. One hundred seventeen children, aged 5 months to 5 years, with acute otitis media and abnormal tympanometric patterns were categorized into three groups —low compliance, high pressure, and low pressure—based on the initial patterns. All the children received oral amoxicillin for ten days. They had repeat tympanometry and otoscopy at 14- and 60-day follow-up visits, and were followed to determine clinical outcomes.
Results : Initial treatment success was equivalent for all groups: low compliance 93% (95% confidence interval 81%-97%), high pressure 91% (95% CI 71%-98%), and low pressure 89% (95% CI 59–99%). Rates of relapse, reinfection, 90-day non-recurrence, and persistent otoscopic and tympanometric middle ear effusion did not differ significantly between groups.
Conclusion : ED tympanometry of children with acute otitis media is unable to provide prognostic information regarding treatment failure, recurrent infection, or persistent middle ear effusion. 相似文献
Methods : A prospective observational study was performed in the EDs of a county hospital and a university medical center. One hundred seventeen children, aged 5 months to 5 years, with acute otitis media and abnormal tympanometric patterns were categorized into three groups —low compliance, high pressure, and low pressure—based on the initial patterns. All the children received oral amoxicillin for ten days. They had repeat tympanometry and otoscopy at 14- and 60-day follow-up visits, and were followed to determine clinical outcomes.
Results : Initial treatment success was equivalent for all groups: low compliance 93% (95% confidence interval 81%-97%), high pressure 91% (95% CI 71%-98%), and low pressure 89% (95% CI 59–99%). Rates of relapse, reinfection, 90-day non-recurrence, and persistent otoscopic and tympanometric middle ear effusion did not differ significantly between groups.
Conclusion : ED tympanometry of children with acute otitis media is unable to provide prognostic information regarding treatment failure, recurrent infection, or persistent middle ear effusion. 相似文献
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鼻内窥镜下经咽鼓管咽口注药治疗慢性分泌性中耳炎119例 总被引:1,自引:0,他引:1
【目的】探讨在内窥镜下经咽鼓管咽口注入药物治疗慢性分泌性中耳炎(SOM)的疗效。【方法】慢性分泌性中耳炎患者119例(184耳),男性78例、女性41例,平均年龄38.7(6~68)岁。34例(68耳)患者中18例确诊腺样体肥大,16例变应性鼻炎,34例患者经咽鼓管仅灌注一次药物治愈;33例(40耳)患者为慢性鼻窦炎,鼻息肉或鼻中隔偏曲,清除鼻咽和咽鼓管口的脓性分泌物,经咽鼓管咽口灌注药物2~4次;51例(76耳)鼻咽癌放疗后的患者,先行鼻咽部瘢痕松解、脓痂清除及咽鼓负管咽口扩张注药6~9次。【结果】腺样体肥大和变应性鼻炎34例患者一次性注药恢复正常,仅1例注药2次;33例慢性鼻窦炎,鼻息肉或鼻中隔偏曲患者中25例一次治疗完全康复,8例患者经2~4次治疗后康复;52例鼻咽癌放疗后的患者须经反复注药6~9次治疗才痊愈。【结论】因鼻腔、鼻窦、鼻咽病变导致慢性分泌性中耳炎,在治疗原发疾病的同时,经咽鼓管咽口置管注药是治疗最为有效的方法。此方法创伤小、痛苦轻、疗效好。 相似文献