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目的:研究鼓膜置管术后通气管阻塞的危险因素以及相应的应对措施。方法:回顾性分析2010-02-2015-02期间行鼓膜置管的145例患者(198耳),术后未滴药;以及2015-03-2016-02期间行鼓膜置管的59例患者(80耳),该组术后均给予氧氟沙星滴耳液。分别在术后1、3、6、12个月随访,检查通气管的位置,是否有阻塞发生。如发现干痂、耵聍或血痂阻塞,应用4%碳酸氢钠滴耳液滴耳后清理,根据清理结果和是否再次出现积液情况,采取随访或再次置入新的通气管。对于有脓性分泌物的患者,给予3%双氧水和氧氟沙星滴耳液,使通气管再通。结果:在未滴药的145例(198耳)中,共有16例患者出现通气管阻塞,其中管腔内干痂阻塞8例,血痂阻塞或覆盖通气管3例,耵聍阻塞3例,脓性分泌物2例。滴药的59例患者中,共有7例出现通气管阻塞,其中管腔内干痂阻塞1例,血痂阻塞或覆盖通气管1例,耵聍阻塞4例,脓性分泌物1例。结论:鼓膜置管术后通气管阻塞较为常见,术中、术后可进行预防和处理,术后短期抗生素滴耳可以有效预防通气管阻塞和术后感染的发生。
Objective: To study the risk factors of ventilation tube obstruction after tympanic membrane catheterization and the corresponding countermeasures. METHODS: A total of 145 patients (198 ears) undergoing tympanic membrane catheterization during 2010-02-2015-02 were retrospectively analyzed. No drip medicine was administered after operation. Fifty-nine patients undergoing tympanic membrane catheterization during 2015-03-2016-02 80 ears), the group were given ofloxacin ear drops. Respectively 1,3,6,12 months after follow-up, check the position of the ventilation tube, whether blockage occurred. If found dry scab, scrofa or blood clots obstruction, the application of 4% sodium bicarbonate ear drops ear cleaning, according to the results of the clean-up and whether the recurrence of fluid situation, follow-up or re-placement of the new vent. For patients with purulent secretions, give 3% hydrogen peroxide and ofloxacin ear drops, the ventilation tube recanalization. Results: Among the 145 cases (198 ears) without drops, a total of 16 patients had occlusion of the ventilation tube, including 8 cases of dry scab block in the lumen, 3 cases of blood clots occlusion or covering ventilation tube, 3 cases of clogged obstruction, Purulent secretions in 2 cases. Among the 59 patients who received drip, 7 cases had obstruction of ventilation tube, including 1 case with dry scab in the lumen, 1 case with clotting or covering of the blood vessel, 4 cases of obstruction and 1 case of purulent discharge. Conclusion: Ventilation tube obstruction after tympanic membrane catheterisation is more common. Intraoperative and postoperative can prevent and treat. Postoperative short-term antibiotic ear drops can effectively prevent occlusion of ventilation tube and postoperative infection.