Application of a modified tympanic membrane surgical knife with suction and tube device in myringotomy with ventilation tube placement
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摘要: 目的: 探讨采用鼓膜切开吸引刀与改良置管器置T型管行鼓膜置管术治疗分泌性中耳炎的临床疗效。方法: 对2014-06-2015-12期间收治的87例分泌性中耳炎患者,随机分组为普通法置管组及改良法置管组。对总有效率、术后3个月内脱管率、瘢痕形成或鼓膜萎缩率、手术时间及一次性置管成功率等临床数据进行分析。结果: 两组在总有效率、术后3个月内脱管率及瘢痕形成或鼓膜萎缩率方面差异均无统计学意义(P>0.05);普通法置管组手术时间为(11.4±4.3)min,改良法置管组手术时间为(8.1±3.6)min,普通法置管组一次性置管成功率81.2%,改良法置管组一次性置管成功率93.7%,差异均有统计学意义(P<0.05)。结论: 采用改良法置管能有效缩短手术时间,提高一次性置管成功率,避免因反复操作而导致的鼓膜及外耳道损伤。Abstract: Objective: To explore the efficacy of a modified tympanic membrane surgical knife with suction and tube device in myringotomy with ventilation tube placement for the treatment of secretory otitis media.Method: From June of 2014 to December of 2015, 87 cases of secretory otitis media were randomly divided into two groups:One group was treated by general approach to achieve tympanic membrane tube insertion, and another group with modified method. The total effective rate,the rate of tube detachment at 3 months postoperatively, the rate of scar formation or tympanic membrane atrophy, the operation time and the success rate of tube insertion for the first time in two groups were analyzed retrospectively.Result: There was no significantly difference between two groups about the total effective rate,the rate of tube detachment and the rate of scar formation or tympanic membrane atrophy(P>0.05). However, the duration of operation in general method group[(11.4±4.3 min)]was significantly longer than that in modified method group[(8.1±3.6)min](t=5.412,P<0.05). In addition, the success rate of tube insertion in general group(81.2%) was significantly lower than that in modified group(93.7%)(χ2=5.397,P<0.05).Conclusion: The modified method contributed to shorten the duration of operation, improved the success rate of tube insertion and avoided the injury of tympanic membrane and external auditory canal caused by repeated operation.
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