创伤性鼓膜穿孔不同修复方式的临床观察  

Evaluation of influencing factors and different repair mechanism of tympanic membrane perforations

作　　者：楼正才[1] 胡云星 张艳慧 陈华英[1] 杨剑[1] 

机构地区：[1]义乌市中心医院耳鼻咽喉科,浙江义乌322000 [2]义乌市公安局法医科 [3]金华市中医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第1期20-22,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2009年浙江省科技计划一般项目(No:2009C33097)

摘　　要：目的:探讨创伤性鼓膜穿孔自然愈合及贴膜修复对穿孔愈合的影响。方法:将2007-06-2009-03共112例创伤性鼓膜穿孔患者随机分为2组,分别予以自然修复(自然愈合组,57例)及贴膜处理(贴膜组,55例),内镜下动态观察穿孔愈合情况。结果:随访3个月,贴膜组55例,失访9例,穿孔边缘肉芽增生36例,小、中、大穿孔愈合率分别为100.00%、90.48%、93.33%,愈合时间分别(9.0±2.8)d、(13.0±2.6)d、(22.0±4.7)d。自然愈合组57例,失访11例,小、中、大穿孔愈合率分别为91.67%、95.24%、84.62%,愈合时间分别为(11.0±3.7)d、(24.0±3.8)d、(36.0±2.1)d,其中,5例上皮错向移行,2例手术。2组中、大穿孔愈合时间比较均差异有统计学意义(均P<0.05)。结论:创伤性鼓膜穿孔贴膜处理可促进穿孔缘水肿、肉芽增生,加速穿孔愈合,肉芽增生程度与愈合时间密切相关;自然愈合过程上皮错向移行可抑制穿孔愈合。Objective：Evaluation of different repair mechanism and influencing factors for Prognosis of tympanic membrane perforations.Method：One hundred and twelve female patients of tympanic membrane perforations were randomly divided into two groups： control group （natural repair group ）and treatment group（gelatin sponge patch bonded repair group）, The perforation healing were dynamically observed in two groups by endoscope.Result：The result show that low, medium and high perforations healing rates were 100.00%,90.49%,93.33%,The healing time of low, medium and high was（9.0±2.8）d,（13.0±2.6）d,（22.0±4.7）d, the epithelial layer reverse growth in 5cases, The result show that low, medium and high perforations healing rates were 91.67%,95.24%,84.62%,The healing time of low, medium and high was（11.0±3.7）d,（24.0±3.8）d,（36.0±2.1）d, 2 cases were undergone surgeries.Conclusion：There are differences in repair mechanism between natural repair and patch bonded repair. patch bonded repair can promote granulation hyperplasia, it can help recovering and lessening the patient＇s conductive hearing loss and occasional tinnitus. granulation hyperplasia and the healing time is closely related. the epithelial layer reverse growth may affect the healing of tympanic membrane perforation.

关 键 词：鼓膜穿孔 治疗 内镜 

分 类 号：R764.29[医药卫生—耳鼻咽喉科]