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目的总结放射性损伤引起的分泌性中耳炎的治疗经验。方法回顾性分析102耳放射治疗并发分泌性中耳炎的临床资料,针对患者采用序贯治疗,首先采用药物对症和对因治疗1～2周,保守治疗无效者先行鼓膜穿刺抽液术,多次穿刺抽液无效者可行鼓膜切开置管术。结果102耳保守治疗1～2周后有效者仅6耳;无效的96耳经鼓膜穿刺抽液术治愈的有59耳,治愈率为61.4%(59/96),穿孔5耳,穿孔率5.2%(5/96),未愈32耳;对未愈的32耳行鼓膜切开置管术,治愈率为25.0%(8/32),未愈24耳中单纯穿孔13耳,合并感染11耳,术后感染率为45.8%(11/24),穿孔率54.2%(13/24)。结论单纯保守治疗放射引起的分泌性中耳炎效果较差,虽然鼓膜穿刺抽液术和鼓膜切开置管术均为治疗分泌性中耳炎的常用方法,但对放射性损伤引起的分泌性中耳炎,建议多采用鼓膜穿刺抽液术,慎重选择鼓膜切开置管术。
Objective To summarize the therapeutic experience of secretory otitis media caused by radioactive injury. Methods A retrospective analysis of 102 cases of radiation-assisted otitis media with secretory clinical data for patients with sequential treatment, the first use of drug symptomatic and due to treatment for 1 to 2 weeks, conservative treatment ineffective first tympanic membrane aspiration, multiple puncture Pumping ineffective feasible tympanotomy catheterization. Results One hundred and two ears of conservative treatment were only 6 ears after conservative treatment for one to two weeks. Sixty-nine ears were cured by tympanic membrane aspiration, the cure rate was 61.4% (59/96), perforated 5 ears and perforation rate of 5.2 % (5/96), healed 32 ears; unhealed 32 ears line tympanotomy incision catheterization, the cure rate was 25.0% (8/32), unhealed 24 ears perforated 13 ears, with infection 11 Ear, postoperative infection rate was 45.8% (11/24), perforation rate 54.2% (13/24). Conclusions The conservative treatment of radiation-induced otitis media with effusion is less effective. Although tympanic membrane aspiration and tympanotomy are commonly used in the treatment of secretory otitis media, it is recommended to use more otitis media with otitis media with radiation-induced otitis media Tympanic membrane aspiration, carefully choose the tympanic membrane incision catheterization.