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目的探讨鼓膜置管对鼻咽癌(NPC)患者放疗前后分泌性中耳炎(SOM)的疗效。方法2005年3月-2010年1月将60例(84耳)NPC并发SOM患者分为两组:A组30例行鼓膜切开鼓膜置管;B组30例保守治疗为对照组,并行随访,对两组患者有效率和并发症发生率进行统计。结果60例中58例存活,1例死于全身衰竭,1例死于大出血。存活患者中治疗SOM有效率为:A组85.4%(35/41),B组为30.2%(13/43),两组差异有统计学意义(P<0.05);并发症发生率A组为14.6%(6/41),B组为69.8%(30/43),B组并发症高于A组,差异有统计学意义(P<0.05)。结论NPC患者在放疗后,咽鼓管功能受到严重损害,是不可逆的病变,鼓膜置管治疗NPC并发SOM较保守治疗效果好,并发症的发生率低。
Objective To investigate the effect of tympanic membrane catheterization on the pathogenesis of secretory otitis media (SOM) in patients with nasopharyngeal carcinoma (NPC) before and after radiotherapy. Methods From March 2005 to January 2010, 60 patients (84 ears) with SOM complicated by NPC were divided into two groups: 30 cases in group A underwent eardrum tympanotomy; 30 cases in group B received conservative treatment as control group and were followed up , The two groups of patients with efficiency and complication rate statistics. Results Of 60 cases, 58 survived, 1 died of systemic failure and 1 died of bleeding. Survival patients in the treatment of SOM efficiency: A group 85.4% (35/41), B group was 30.2% (13/43), the difference between the two groups was statistically significant (P <0.05); the incidence of complications in group A 14.6% (6/41) in group B, 69.8% (30/43) in group B, and the complication in group B was higher than that in group A (P <0.05). Conclusion After radiotherapy, the eustachian tube function of NPC patients is severely damaged. It is an irreversible lesion. Nasopharyngeal catheterization is more effective than conservative treatment for NPC complicated with conservative SOM, and the incidence of complications is low.