耳内镜与显微镜下鼓膜成形术的临床疗效比较  

Comparison of endoscope assisted myringoplasty and microscopic myringoplasty

作　　者：凡启军[1] 倪丽艳[1] 项松洁[1] 高金建[1] 黄赛瑜[1] 陈波蓓[1] Qi-jun Fan;Li-yan Ni;Song-jie Xiang;Jin-jian Gao;Sai-yu Huang;Bo-bei Chen(Department of Otorhinolaryngology,the Second Hospital affiliated to Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院耳鼻咽喉科,浙江温州325027

出　　处：《中国内镜杂志》2018年第10期34-38,共5页China Journal of Endoscopy

基　　金：浙江省医药卫生科技计划项目(No:2014KYA140)

摘　　要：目的比较耳内镜下鼓膜成形术与传统显微镜下手术方式患者的临床疗效并进行分析。方法选取2015年1月-2016年12月在温州医科大学附属第二医院耳鼻咽喉科住院行鼓膜成形术患者72例(72耳),将其随机分为耳内镜手术组和显微镜手术组,其中耳内镜组和显微镜组各36例。比较两种手术方式下患者的手术时间、术中出血量、术后24 h内疼痛程度、术后平均住院时间、术后穿孔愈合及听力恢复情况等。结果耳内镜手术组在手术时间、术中出血量、术后24 h内疼痛程度及术后平均住院时间上均优于显微镜手术组(P <0.05),两组术后鼓膜穿孔愈合率及听力改善情况差异无统计学意义(P>0.05)。结论耳内镜下鼓膜成形术具有创伤小,术后疼痛反应轻等优点,同时缩短患者的住院时间,患者术后穿孔愈合及听力恢复效果与显微镜下手术相当,值得临床推广应用。Objective To compare the clinical efficacy of endoscopic versus microscopic approach to myringoplasty.Methods In this prospective study,the outcomes of 72 ears of 72 patients underwent myringoplasty were evaluated from January 2015 to December 2016 and randomly divided into group 1 and group 2.Group 1 underwent myringoplasty with an endoscopic technique(n=36),and Group 2 underwent myringoplasty with the conventional microscopic technique(n=36).The operating time,intraoperative blood loss,postoperative incision pain,average hospitalization time,hearing recovery and graft success rate were compared between the two groups.Results The operating time,intraoperative blood loss,postoperative incision pain,average hospitalization time of Group 1 were significantly lower than that in Group 2(P<0.05).There were no significant differences between the preoperative and postoperative air-bone gap values(in dB)in either group(P>0.05).The difference between the graft success rate was not significant in either group(P>0.05).Conclusions Myringoplasty with an endoscopic technique holds many advantages:less pain,good efficacy,simple manipulation,reduced length of hospitalization and can get the same curative effect.Therefore,it is worthy of promoting clinical application.

关 键 词：鼓室成形术 耳内镜 鼓膜穿孔 

分 类 号：R764.82[医药卫生—耳鼻咽喉科]