耳内镜用ADM和传统显微镜行鼓室成形术Ⅰ型的术后生活质量对比研究  

A comparative study of quality of life in patients with type I endoscopic tympanoplasty with ADM and conventional microscopy

作　　者：白燕芳[1] 郑立岗[1] 虞幼军[1] 刘振[1] 

机构地区：[1]佛山市第一人民医院,528000

出　　处：《国际医药卫生导报》2017年第24期3840-3843,共4页International Medicine and Health Guidance News

基　　金：佛山市卫生和计划生育局医学科研项目（20160061）

摘　　要：目的比较耳内镜下用组织工程材料ADM行鼓室成形术Ⅰ型（即中耳炎微创手术）和传统显微镜行鼓室成形术I型术后早期的生活质量的差异。方法选择行鼓室成形术Ⅰ型的慢性中耳炎80例，其中中耳炎微创手术组和传统耳显微手术组各40例，采用问卷调查方式，探讨慢性中耳炎病人分别行中耳炎微创手术和传统耳显微手术术后早期的生活质量差别。应用中文版慢性耳病调查量表（CCES）和视觉模拟量表（Visual Analogue Scale，VAS），对全部符合纳入标准的慢性中耳炎（COM）患者进行问卷调查，分别在术前及手术当天、术后3d、2周对两组患者进行生活质量评分并进行比较；并采用自制的患者手术满意程度调查表进行手术后随访。结果本组研究患者共80例，随访率为100％。在CCES评分中两组手术当天活动限制、症状、医疗资源和术后3d活动限制、医疗资源占用评分比较，微创手术组评分较高，优于传统耳显微手术组，差异有统计学意义（P〈0．05）；其余两组手术评分比较差异均无统计学意义（均P〉0．05）；VAS评分中微创手术组术前及手术当天、术后3d、2周仅存在轻度困扰，传统耳显微手术组多数存在中度困扰；中耳炎微创手术组满意度为92．5％，传统耳显微手术组为70．0％，中耳炎微创手术组优于传统耳显微手术组（P〈0．05）。结论中耳炎微创手术具有微创、体表无切口、视野清晰、操作简便精确、愈合率高、恢复快等特点，能显著提高患者术后早期的生活质量和手术满意度，在临床上有广阔的应用前景。Objective To compare the early quality of life in patients with type I endoscopic tympanoplasty （minimally invasive surgery for otitis media） with tissue engineering materials ADM and conventional microscopy. Methods 80 cases of chronic otitis media scheduled for type I endoscopic tympanoplasty were divided into minimally invasive surgery for otitis media group and traditional ear microsurgery group with 40 cases in each group. The early postoperative quality of life of the two groups were investigated respectively with the questionnaire survey. The questionnaire survey was carried out on patients with chronic otitis media （COM） who met the inclusion criteria with Chinese version of chronic ear disease questionnaire （CCES） and Visual Analogue Scale （VAS）. The scores of quality of life were compared between the two groups before operation, on the day of operation, 3 days and 2 weeks after operation. The self-made patient satisfaction questionnaire was used during the follow-up. Results A total of 80 patients were followed up, with a follow-up rate of 100%. CCES scores including activity restriction, symptoms, occupancy of medical resources in the minimally invasive surgery group on the day of operation, CCES scores including activity restriction and occupancy of medical resources in the minimally invasive surgery group 3 days after operation were significantly higher than those in the traditional ear microsurgery group, with statistically significant differences （P〈0.05）. VAS score result showed that there was just mild distress in the minimally invasive surgery group before operation, on the day of operation, 3 days and 2 weeks after operation; there was moderate distress in the traditional ear microsurgery group. The patient satisfaction in the minimally invasive surgery group was better than that in the traditional ear microsurgery group （92.5% vs.70.0%; P〈0.05）. Conclusion Minimally invasive surgery for otitis media has the advantages of minimally invasive, no incision on the body s

关 键 词：中耳炎 耳内镜 ADM 鼓室成形术 生活质量 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]