异种脱细胞真皮基质联合自体骨粉在开放式鼓室成形术中的应用  

Clinical application of heterogeneous acellular dermal matrix with autologous bone meal in open tympanoplasty

作　　者：李军政[1,2] 田文栋[1] 韩明鲲[3] 许教远 高翔 李湘平[1] 

机构地区：[1]南方医科大学南方医院耳鼻咽喉-头颈外科,广州510515 [2]东莞市第五人民医院耳鼻咽喉-头颈外科 [3]中国人民解放军总医院耳鼻咽喉-头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第19期1465-1468,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广东省自然科学基金(No:10151051501000068);东莞市卫生科技基金项目(No:201210515025055)

摘　　要：目的：探讨异种脱细胞真皮基质联合自体骨粉在开放式鼓室成形术中的临床价值。方法：将50例（52耳）行开放式鼓室成形术的中耳胆脂瘤患者分为2组。研究组28例（30耳）患者行开放式鼓室成形术＋异种脱细胞真皮基质联合自体骨粉外耳道重建术;对照组22例（22耳）行常规开放式鼓室成形术。术后随访12-18个月,观察2组患者术后听力结果、干耳率及并发症情况。结果：研究组干耳率90.0%（27/30）,明显高于对照组72.7%（16/22）,差异有统计学意义（P〈0.05）。研究组重建后的外耳道结构接近正常,无狭窄情况发生,中耳腔接近正常,全部患者均无胆脂瘤复发。结论：应用脱细胞真皮基质联合自体骨粉能够起到早期覆盖创面,促进创面愈合,缩小外耳道,减少肉芽及瘢痕生成的作用,术后干耳率高,听力恢复满意,是一种值得推广的修复方法。Objective：To evaluate the clinical value of heterogeneous acellular dermalmatrix with autologous bone meal in open tympanoplasty.Method：Twenty-eight cases（30ears）with middle ear cholesteatoma were treated by open tympanoplasty and repaired by heterogeneous acellular dermalmatrix autologous bone meal on study team.Twenty-two cases（22ears）with middle ear cholesteatoma were treated by open tympanoplasty on control team.All patients were followed up for 12 to 18months and assessed the fuction postoperatively.Result：The reconstruction of external auditory canal structure is close to normal,and no narrow happens on study team.The rate of dry ear was about 90%.All cases had no recurrence of cholesteatoma.Conclusion：Application of decellularized dermal matrix with autologous bone meal can rise early to cover the wound,promote wound healing and to reduce the external auditory canal,reduce the effect of granulation and scar formation.It is a kind of method of repair to be promoted.

关 键 词：异种脱细胞真皮基质 鼓室成形术 胆脂瘤中耳 修复外科手术 

分 类 号：R764[医药卫生—耳鼻咽喉科]