耳显微镜下明胶海绵吸附自体血贴补修复外伤性鼓膜穿孔162例体会  

Experience of 162 Cases of Traumatic Tympanic Membrane Perforation Repaired by Glue-sponge Adsorption Autogenous Blood Patch Under Ear Microscope

作　　者：尚玉堂 赵浩然 SHANG Yutang;ZHAO Haoran(PLA 478 Hospital,Kunming650200,China)

机构地区：[1]中国人民解放军第478医院,云南昆明650200 [2]中国人民解放军昆明疗养院

出　　处：《中外医学研究》2018年第25期127-129,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究耳显微镜下明胶海绵吸附自体血贴补修复外伤性鼓膜穿孔的效果。方法:选择2012年1月-2017年12月笔者所在医院收治的162例外伤性鼓膜穿孔患者为研究对象,所有患者均给予明胶海绵吸附自体血贴补修复治疗,观察患者鼓膜穿孔修复的手术效果及语言频率(0.5、1、2 kHz)平均气骨导差值是否提高。结果:162例患者中治愈48例,好转90例,无效24例,总好转率为85.2%。患者治疗后的平均气骨导差值显著高于治疗前,差异有统计学意义(P<0.05)。其中3例患者出现排斥反应,半年后采用取乳突部骨膜行鼓膜修补术后治愈。2例穿孔鼓膜术后部分愈合,患者不愿再手术,半年后失访。其余穿孔者全部愈合。结论:耳显微镜下明胶海绵吸附自体血贴补修复外伤性鼓膜穿孔效果显著,排斥反应少,值得临床推荐。Objective：To explore the effect of gelatinized sponge on repairing traumatic tympanic membrane perforation by absorbing autogenous blood patch under ear microscope.Method：From January 2012 to December 2017,162 patients of traumatic tympanic membrane perforation in our hospital were selected as the research object,all the patients were given gelatin sponge adsorption of autologous blood repairing treatment,tympanic membrane perforation repair surgery effect and language frequency（0.5,1 and 2 k Hz） average bones difference whether to raise was observed.Result：Among 162 patients,48 were cured,90 were improved,24 were invalid,and the total conversion rate was 85.2%.The mean pneumo-bone conduction difference of patients after treatment was significantly higher than that before treatment,the difference was statistically significant（P0.05）.3 cases had a rejection reaction,and half a year later,they were cured by taking the periosteum of the mastoid process and repairing the tympanic membrane.2 cases of perforated tympanic membrane partially healed after surgery,the patient was unwilling to operate again and lost the visit half a year later.All other perforations healed.Conclusion：Under the auricular microscope,gelfoam can effectively repair traumatic tympanic membrane perforation with less rejection,which is worthy of clinical recommendation.

关 键 词：耳显微镜 明胶海绵吸附 自体血 外伤性鼓膜穿孔 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]