一期人工听骨植入临床疗效研究与分析  

Clinical effect of artificial ossicle replacement

作　　者：吴松林 李茜 肖章建 龙卫东 

机构地区：[1]张家界市人民医院耳鼻咽喉科,湖南张家界427000

出　　处：《中国耳鼻咽喉颅底外科杂志》2015年第3期214-216,219,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的观察人工听骨与自体听骨在听骨链重建术后的疗效,寻找应用于听力重建的更好材料。方法2010年3月-2013年9月具有完整临床资料且行听骨链重建术的患耳（125耳）,术后随访6-24个月,结合术前听力学资料,分析不同术式的听力疗效。结果 125耳患者中,行人工听骨听力重建81耳,其中部分人工听骨57耳,全人工听骨24耳;行自体听骨听力重建44耳。部分人工听骨组术前、术后1个月及术后6个月的平均听阈分别为（56.72±10.20）、（34.13±8.36）、（32.67±10.12）d B,术后与术前比较差异具有统计学意义（P〈0.05）;全人工听骨组术前、术后1个月及术后6个月的平均听阈分别为（65.19±8.63）、（37.47±9.23）、（35.14±8.96）d B,术后与术前比较差异具有统计学意义（P〈0.05）;自体听骨组术前、术后1个月及术后6个月的平均听阈分别为（51.32±16.31）、（36.13±10.07）、（42.13±9.25）d B,术后与术前比较差异无统计学意义（P〉0.05）。结论人工听骨是一种可在听骨链重建中推广的人工听骨材料,术后能取得良好的听力效果。Objective To compare the effect of ossicular reconstruction with artificial ossicle and autologous ossicle,in order to find better implant material for ossicular reconstruction. Methods Clinical data of 125 cases receiving ossicular reconstruction in our hospital between March 2010 and Sept 2013 were studied retrospectively. Audiological tests were performed in all patients before operation,one and 6 months after operation respectively. Results Among all 125 cases,81 cases underwent artificial ossicle reconstruction and 44 cases experienced autologous ossicle reconstruction. Of the 81 cases underwent artificial ossicle reconstruction,57 were reconstructed with partial ossicular replacement prosthesis（ PORP） and 24 with total ossicular replacement prosthesis（ TORP）. In the PORP group,the average air conduction hearing thresholds before operation,one and 6 months after operation were（ 56. 72 ± 10. 20）,（ 34. 13 ± 8. 36） and（ 32. 67 ± 10. 12） d B,respectively. The differences between preoperative and postoperative hearing thresholds were statistically significant（ P〈 0. 05）. For the TORP group,the values were（ 65. 19 ± 8. 63）,（ 37. 47 ± 9. 23） and（ 35. 14± 8. 96） d B respectively,and the differences were also significant（ P〈 0. 05）. As for the autologous reconstruction group,the hearing thresholds were（ 51. 32 ± 16. 31）,（ 36. 13 ± 10. 07） and（ 42. 13 ± 9. 2） d B,the differences were statistically insignificant（ P〉 0. 05）. Conclusion Artificial ossicle is a useful implant material for ossicular reconstruction,and hearing improvement will be obtained after artificial ossicular reconstruction for patients with otitis media.

关 键 词：人工听骨 听骨链重建 慢性化脓性中耳炎 听力学分析 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]