数字耳镜定量测量系统检测鼓膜病变的临床研究  

Clinical study about defining pathological changes of tympana by digital otoscope

作　　者：杨妙丽[1] 赵振怀[1] 李娜[1] 

机构地区：[1]西安交通大学医学院第二附属医院耳鼻咽喉科,西安710004

出　　处：《陕西医学杂志》2011年第2期159-160,162,共3页Shaanxi Medical Journal

基　　金：西安市科技计划项目(GG04143)

摘　　要：目的:探讨数字耳镜定量测量系统在鼓膜病变诊断中的应用。方法:通过内窥镜电脑成像系统对中耳病变的鼓膜穿孔648例678耳大小、部位、形态、有无分泌物等进行检查,采用数字耳镜测量系统测量穿孔的准确面积,根据测量数据进行定量分析。结果:通过检测发现慢性中耳炎鼓膜穿孔222例242耳,多发生在前下象限,其次为后下象限和中央部,松弛部穿孔较少见。鼓膜穿孔的形态以圆形或类圆形多见,穿孔边缘多比较整齐。本组穿孔位于前下象限170耳,占穿孔总数的70.2%;后下象限39耳,占16.1%;中央型穿孔27耳,占11.2%;松弛部穿孔6耳,占2.5%。外伤性鼓膜穿孔426例436耳患者检测,发现穿孔多发生在前下象限,其次为后下象限和中央部;鼓膜穿孔的形态以类圆形、不规则形、三角形、梭形多见,部分为圆形、裂隙形穿孔;穿孔位于前下象限339耳,后下象限70耳,中央型穿孔27耳。穿孔面积小于1/2象限或7mm2以内者244耳;穿孔大于1/2象限,但不超过两个象限或面积大于7mm2,小于或等于20mm2者260耳;穿孔大于两个象限或面积大于20mm2者174耳。结论:应用数字耳镜定量测量系统检测中耳病变鼓膜穿孔,不仅可以检测出穿孔的范围、大小、形态,而且可以测量穿孔的面积,为临床治疗鼓膜穿孔提供了思路。Objective：To discuss defining pathological changes of tympana by digital otoscope.Methods：By digital otoscope,we checked size,shape,location and measured exact area of tympana perforation at 678 ears of 648 patients.Results： Tympana perforations caused by tympanitis at 242 ears of 222 patients were checked.Majority of them were round in shape.The edges of the perforations were formal.70.2% of perforations（at 170 ears） were at the front nether quadrant,the 16.1%（at 39 ears） were at the hinder nether quadrant,the 11.2%（at 27 ears） were central,and the 2.5%（at 6 ears） were at flaccid part.Tympana perforations caused by traumatism at 436 ears of 426 patients were also checked.They were variety in shape.Perforations of 339 ears were at the front nether quadrant,those of 39 ears were at the hinder nether quadrant,and central perforations were at 27 ears.Area of perforation at 244 ears were less than 1/2 quadrant（or 7 mm2）,that of 260 ears were more than 1/2 quadrant（or 7 mm2） but less than 2 quadrant（or 20 mm2）,and it were more than 2 quadrant （or 20 mm2） at 174 ears.Conclusion： By digital otoscope,not only scope and shape of perforation can be checked,but also area can be measured,which may give more exact clinical data.

关 键 词：鼓膜穿孔/诊断 内窥镜检查 @耳镜定量测量系统 

分 类 号：R764.29[医药卫生—耳鼻咽喉科]