Li Z F, Yi S J, Wang W H, He X S, Liu Q H
Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Guilin Medical College, Guilin, 541001, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Mar;32(5):383-385. doi: 10.13201/j.issn.1001-1781.2018.05.016.
This study aims to the comparative study of AT+A (adenoidectomy with acupuncture) and AT+T (adenoidectomy with tympanonstomy tube) to monitor and compare the therapeutic effect and prognosis of secretory otitis media in children. The study make a summary and give the clinical suggestions as well.We collected and analyzed 280 outpatients of children secretory otitis media from March 2015 to March 2016.Among them,172 cases took the adenoidectomy with acupuncture and 108 cases took the adenoidectomy with tympanonstomy tube. This research used the therapeutic effect indicators,middle ear effusion time and one year follow-up to evaluate the pros and cons of two surgery methods in different areas.The patients of both groups had relatively good therapeutic effect which promoted with time. There were no significant difference between AT+A and AT+T in tympanic membrane. While AT+T group acted better than AT+A group in pure tone average and tympanum figure. The middle ear effusion time of AT+T group was significantly shorter than AT+A group. In one year follow-up, there were no difference in hearing loss between two groups.But AT+T group performed better in recurrence rate, infection rate and total rate.Since the adenoidectomy with tympanonstomy tube method has a lot of advantages over adenoidectomy with acupuncture,it's better to use AT+T in severechildren secretory otitis media when situation is available.
本研究旨在对腺样体切除术联合针灸（AT+A）与腺样体切除术联合鼓膜置管（AT+T）进行对比研究，以监测和比较儿童分泌性中耳炎的治疗效果及预后。同时对研究进行总结并给出临床建议。我们收集并分析了2015年3月至2016年3月期间280例儿童分泌性中耳炎门诊患者。其中，172例行腺样体切除术联合针灸，108例行腺样体切除术联合鼓膜置管。本研究采用治疗效果指标、中耳积液时间及一年随访来评估两种手术方法在不同方面的优缺点。两组患者治疗效果均随时间推移较好。AT+A组与AT+T组鼓膜情况无显著差异。而AT+T组在纯音平均听阈和鼓室图方面优于AT+A组。AT+T组中耳积液时间明显短于AT+A组。在一年随访中，两组听力损失无差异。但AT+T组在复发率、感染率及总有效率方面表现更好。由于腺样体切除术联合鼓膜置管法相对于腺样体切除术联合针灸法有诸多优势，在条件允许的情况下，重度儿童分泌性中耳炎最好采用AT+T治疗。
