耳内镜下生物羊膜治疗鼓膜穿孔的疗效观察  

Clinical observation on endoscopic myringoplasty with biological amniotic membrane for the treatment of tympanic membrane perforation

作　　者：祝宝莲 徐冰[1] 黄月娥[1] 周思彦 许珉[2] 侯瑾[2] ZHU Bao-lian;XU Bing;HUANG Yue-e;ZHOU Si-yan;XU Min;HOU Jin(Department of Otolaryngology,Wuzhong People＇s Hospital of Suzhou City,Suzhou 215128,China;Hospital of ENT Diseases,the Second Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710004,China)

机构地区：[1]苏州市吴中人民医院耳鼻咽喉科,江苏苏州215128 [2]西安交通大学第二附属医院耳鼻咽喉科病院,陕西西安710004

出　　处：《中国耳鼻咽喉颅底外科杂志》2018年第5期468-471,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨耳内镜下利用生物羊膜移植行鼓膜穿孔修补术的临床疗效。方法选取苏州市吴中人民医院2015年4月～2017年3月收治的38例(38耳)接受耳内镜下采用生物羊膜行鼓膜穿孔修补术患者为研究对象。对所有患者术后3、6个月鼓膜穿孔愈合情况以及术后6个月听力恢复情况进行统计学分析。结果 38例患者术后3、6个月鼓膜愈合分别为36(94. 7%)、35(92. 1%);术后6个月复查纯音测听气导平均听阈为(28. 42±7. 31) d B,较术前提高(17. 19±5. 31) d B;手术前后听力比较差异具有统计学意义(t=10. 091,P﹤0. 05)。结论耳内镜下利用生物羊膜行鼓膜修补术,避免了自体取材造成的手术切口创伤与瘢痕,且具有手术时间短,患者术中出血量少等优点,为鼓膜穿孔提供了一种微创、安全有效、相对经济的治疗方法,值得临床推广应用。Objective To investigate the clinical effect of endoscopic myringoplasty with biological amniotic membrane for treatment of tympanic membrane perforation.Methods 38 patients suffering from tympanic membrane perforation repaired endoscopically with biological amniotic membrane in our hospital from April 2015 to March 2017 were included.The clinical data statistically analyzed included operation time,blood loss,healing of tympanic membrane perforation in 3 months and 6 months after myringoplasty,as well as hearing in 6 months postoperatively.ResultsThe healing rates of tympanic membrane perforation in 3 months and 6 months after surgery were 94.7%（36/38）and 92.1%（35/38）respectively.Postoperative pure tone audiometry revealed that their average air conduction threshold was（28.42±7.31）d B,which was increased by（17.19±5.31）d B compared with the preoperative one.The difference between preoperative and postoperative average air conduction threshold was statistically significant（P〈0.05）.Conclusion With advantages of short operation time,less bleeding,avoidance of surgical incision and scar,endoscopic myringoplasty with biological amniotic membrane is a minimally invasive,safe and effective,economic method for the treatment of tympanic membrane perforation,which is worthy of clinical promotion and application.

关 键 词：生物羊膜 鼓膜穿孔 耳内镜 鼓膜修补 

分 类 号：R764.29[医药卫生—耳鼻咽喉科]