本文選題：中耳炎　切入點(diǎn)：伴滲出液　出處：《臨床耳鼻咽喉頭頸外科雜志》2017年09期

【摘要】：目的:研究鼓膜置管術(shù)后通氣管阻塞的危險(xiǎn)因素以及相應(yīng)的應(yīng)對(duì)措施。方法:回顧性分析2010-02-2015-02期間行鼓膜置管的145例患者(198耳),術(shù)后未滴藥;以及2015-03-2016-02期間行鼓膜置管的59例患者(80耳),該組術(shù)后均給予氧氟沙星滴耳液。分別在術(shù)后1、3、6、12個(gè)月隨訪,檢查通氣管的位置,是否有阻塞發(fā)生。如發(fā)現(xiàn)干痂、耵聹或血痂阻塞,應(yīng)用4%碳酸氫鈉滴耳液滴耳后清理,根據(jù)清理結(jié)果和是否再次出現(xiàn)積液情況,采取隨訪或再次置入新的通氣管。對(duì)于有膿性分泌物的患者,給予3%雙氧水和氧氟沙星滴耳液,使通氣管再通。結(jié)果:在未滴藥的145例(198耳)中,共有16例患者出現(xiàn)通氣管阻塞,其中管腔內(nèi)干痂阻塞8例,血痂阻塞或覆蓋通氣管3例,耵聹阻塞3例,膿性分泌物2例。滴藥的59例患者中,共有7例出現(xiàn)通氣管阻塞,其中管腔內(nèi)干痂阻塞1例,血痂阻塞或覆蓋通氣管1例,耵聹阻塞4例,膿性分泌物1例。結(jié)論:鼓膜置管術(shù)后通氣管阻塞較為常見,術(shù)中、術(shù)后可進(jìn)行預(yù)防和處理,術(shù)后短期抗生素滴耳可以有效預(yù)防通氣管阻塞和術(shù)后感染的發(fā)生。
[Abstract]:Objective: to study the risk factors of ventilation tube obstruction after tympanic membrane catheterization and the corresponding countermeasures. Methods: 145 patients with tympanic membrane tube were treated with tympanic membrane tube during 2010-02-2015-02. And 59 patients who underwent tympanic membrane tube insertion during 2015-03-2016-02 were treated with ofloxacin ear drops after operation. The patients were followed up for 6 and 12 months, respectively, to check the location of the ventilation tube and whether there was any obstruction. If dry scab, cerumen or blood scab were found, After using 4% sodium bicarbonate ear drops to clean the ears, according to the results of cleaning and whether or not there is a recurrence of hydrops, a follow-up or re-placement of a new ventilation tube. For patients with purulent secretions, 3% hydrogen peroxide and ofloxacin ear drops are given. Results: there were 16 patients with obstruction of ventilation tube, including 8 cases of dry callus obstruction in the lumen, 3 cases of blood callus obstruction or covered ventilation tube, 3 cases of cerumen obstruction, and 3 cases of cerumen obstruction. 2 cases of purulent secretions, 7 cases of obstruction of ventilation tube, including 1 case of obstruction of dry callus in the lumen, 1 case of obstruction or overlay of blood callus, 4 cases of cerumen obstruction, 2 cases of purulent secretions, 7 cases of obstruction of ventilation tube, 4 cases of cerumen obstruction. Conclusion: obstruction of ventilation tube is more common after tympanic membrane tube insertion. During operation and after operation, prevention and treatment can be carried out, and short-term antibiotic dropping can effectively prevent obstruction of ventilation tube and postoperative infection.
【作者單位】： 復(fù)旦大學(xué)附屬眼耳鼻喉科醫(yī)院耳鼻咽喉科國(guó)家衛(wèi)計(jì)委聽覺醫(yī)學(xué)重點(diǎn)實(shí)驗(yàn)室上海市聽覺醫(yī)學(xué)臨床中心;
【基金】：國(guó)家自然科學(xué)基金(No:NSFC81300824) 上海市浦江人才資助項(xiàng)目(No:15PJ1401000)
【分類號(hào)】：R764.9

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