本文選題：中耳炎 + 耳外科手術�。� 參考：《重慶醫(yī)科大學》2013年碩士論文

【摘要】：目的:探討與乳突根治術后不干耳相關的術前影響因素，以便臨床工作參考使用。 方法:回顧性分析2008年1月-2012年1月期間，在重慶醫(yī)科大學附屬第二醫(yī)院耳鼻咽喉頭頸外科接受改良乳突根治術治療的慢性化膿性中耳炎患者共90例。通過查閱病歷及隨訪資料，調取研究對象的年齡、病程、性別、藥物過敏史，吸煙史、中耳炎類型、鼻咽部炎癥情況以及致病菌共8個可能影響因素，分析比較并應用多自變量Logistic回歸分析評估各因素對乳突根治術后不干耳的影響。 結果:共90例患者納入研究，總體年齡介于7-74歲，總體病程介于8個月-62年，男：女=42:48。其中干耳組共80例，不干耳組共10例，總體不干耳發(fā)生率為11.1%。在年齡因素組、病程因素組、性別因素組、藥物過敏史因素組及鼻咽部炎癥因素組中，對比組之間的差異無顯著性。在吸煙史因素組中，吸煙患者不干耳發(fā)生率為28.00%，無吸煙史患者不干耳發(fā)生率為4.61%，對比組之間的差異有顯著性（P=0.002，，OR=7.638）。在中耳炎類型因素組中，表皮樣瘤型中耳炎患者不干耳發(fā)病率為4.25%，骨瘍型中耳炎患者不干耳發(fā)病率為18.60%，對比組之間的差異有顯著性（P=0.030，OR=7.937）。在致病菌因素組中，真菌感染致中耳炎患者不干耳發(fā)病率為40.00%，一般細菌感染致中耳炎患者不干耳發(fā)病率為5.33%，對比組之間的差異有顯著性（P=0.000，OR=10.637）。 結論:吸煙患者、骨瘍型中耳炎患者以及真菌感染患者發(fā)生乳突根治術后不干耳的危險性相對較高，為改善手術預后，需充分做好相關圍手術期準備。
[Abstract]:Objective : To investigate the pre - operative influence factors associated with non - dry ear after radical operation for clinical reference .

Methods : From January 2008 to January 2012 , 90 patients with chronic suppurative otitis media were treated with modified mastocarcinoma at the Second Affiliated Hospital of Chongqing Medical University . The age , duration , sex , drug allergy history , smoking history , otitis media type , nasal cavity inflammation and pathogenic bacteria were analyzed and compared .

Results : A total of 90 patients were enrolled in the study , the overall age ranged from 7 to 74 years , the overall course ranged from 8 months to 62 years , male : female = 42 : 48 . There were 80 cases in the dry ear group , 10 cases in the non - dry ear group , and the total dry ear incidence was 11.1 % . In the age factor group , the incidence rate of the non - dry ears in the smoking patients was 28.00 % , the incidence rate of the non - dry ears in the non - smoking history group was 4.61 % , and the difference between the comparison groups was significant ( P = 0.002 , OR = 7.638 ) . In the group of otitis media type , the incidence of non - dry ears in patients with otitis media was 4.25 % and 18.60 % in patients with otitis media , and there was significant difference between the comparison groups ( P = 0.030 , OR = 7.937 ) . In the group of pathogenic factors , the incidence of non - dry ears in patients with otitis media caused by fungal infection was 40.00 % , and the incidence of non - dry ears in patients with otitis media caused by bacterial infection was 5.33 % , and there was significant difference between the comparison groups ( P = 0.000 , OR = 10.637 ) .

Conclusion : The risk of non - dry ear after radical operation in patients with cigarette smoking , bone - selective otitis media and fungal infection is relatively high . In order to improve the prognosis of operation , it is necessary to prepare the relevant perioperative period .
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R765.9

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