耳内镜下鼓膜穿刺与鼓膜置管及盐酸氨溴索冲洗中耳腔治.pdf

·132·ChineseJournalofOtologyVo1．7，No．2，20

·分泌性中耳炎专辑·
耳内镜下鼓膜穿刺与鼓膜置管及盐酸氨溴索冲洗
中耳腔治疗鼻咽癌放疗后分泌性中耳炎
的临床观察

粱健刚陈靖黄郁林张超许庚文卫平李上奎黎志辉胡廷保梁雯
广州市番禺人民医院耳鼻咽喉科(广州511400)

【摘要】目的观察耳内镜下鼓膜穿刺与鼓膜置管及局部应用氨溴索治疗鼻咽癌放疗后分泌性中耳炎的疗效。
方法对112例、145耳鼻咽癌放疗后分泌性中耳炎患者分别行耳内镜下鼓膜穿刺与鼓膜置管及盐酸氨溴索冲洗
中耳腔的治疗对照观察。结果A组(鼓膜置管+盐酸氨溴索冲洗中耳腔)52耳，治愈45耳(86．5％)，好转5耳
(9．6％)，无效2耳，有效率为96．1％；B组(鼓膜置管)53耳，治愈32耳(6O-3％)，好转14耳(26．4％)，无效7耳，
有效率为86．7％；C组(鼓膜穿刺+盐酸氨溴索冲洗中耳腔)40耳，治愈20耳(50％)，好转12耳(3O％)，无效8
耳，有效率为8O％。经Ridit分析，尸<0．05，有显著性差异，A、B两组疗程经t检验，亦有显著性差异。结论应
用盐酸氨溴索冲洗中耳腔结合鼓膜置管治疗放疗后分泌性中耳炎有较好的疗效。
【关键词J内镜；鼓膜置管；盐酸氨溴索；鼻咽癌；放射治疗；分泌性中耳炎
【中图分类号】R739．63，R764．21【文献标识码】A【文章编号】1672-2922(2009)02-0132-03

End0scOpe—guidedmyringocentesisandindwellingcatheterizationwithambroxol

hydrochlorideirrigationforsecretoryotitismediainpatientswith

nasopharyngealcarcinomaafterradiotherapy

LIANGJian-gang,CHEN．ring,HUANGYu-lin，ZHANGChao，XUGeng,WENWei-ping,

LIShang-kui,LIZhi-hui,HU死bao，LIANGWen

ENTDepartment．PanyuPeopleSHospital,Guangzhou511400,Guangdong
【Abstract】ObjectiveToreporttheoutcomesofmyringoeentesisandindwellingcatheterizationwithambroxolhy—
drochlorideirrigationintreatingsecretoryotitismedia(SOM)inpatientswithnasopharyngealcarcinoma(NPC)afterra-
diotherapy．Methods112cases(145ears)ofSOMinNPCafterradiotherapyweretreated．ResultsOfthe52earsthat
receivedindwellingtympanicmembranecatheterandambroxolhydrochlorideirrigation，completeSOMresolutionwas

achievedin45ears(86．5％)andimprovementin5ears(9．6％)，resultinginaneficiencyrateof96．1％．Inthe53ears
treatedwithindwellingtympanicmembranecatheteronly，therewascompleteresolutionin32ears(60_3％)andimprove-
mentinl4ears(26-4％)，withaneficiencyrateof86．7％．Inthe40earsreceivingmyringocentesisandonetimeAmbrox—
olhydrochlorideirrigation，SOMresolvedin20ears(50％)andimprovedin12ears(30％)，yieldinganeficiencyrateof
80％．Thediferencesbetweendifferenttreatmentoutcomeswasstatisticallysignificant．ConclusionIndwellingtympanic

membranecatheterizationcombinedwithambroxolhydrochlorideirrigationprovestobeeffectiveintreatingSOMinpa—

tientswithNP