鼓膜置管治疗鼻咽癌分泌性中耳炎的疗效评价

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。

The Evaluation of Grommet Insertion for Secretory Otitis Media in the Patients of Nasopharyngeal Carcinoma

Objective To evaluate the value of grommet insertion for secretory otitis media（SOM）in the patients with nasopharyngeal carcinoma（NPC）before and after radiotherapy.Methods From March 2005 to January 2010,sixty cases of NPC with SOM were divided into two groups,patients were treated by grommet insertion in group A and by conservative methods in group B.After a long-term follow-up,then the efficient rate and complication rate were compared between two groups.Results Fifty eight cases survived,one patient died of systemic failure,and one died of nasopharyngeal bleeding.In survived patients,the efficient rate in group A was 85.4%（35/41）and 30.2%（13/43）in group B,indicating significant difference in comparison（P〈0.05）,complication rate was 14.6%（6/41）in group A and 69.8%（30/43）in group B,there was significant difference between two groups（P〈0.05）.Conclusion When patients with NPC are treated after radiotherapy,their Eustachian tube function is generally compromised by irradiation,which is irreversible and needs active treatment.The value of grommet insertion is superior to conservative treatment in patients of NPC with SOM,and the incidence of complications is also lower than conservative treatment.