开放式鼓室成形术治疗慢性化脓性中耳炎对患者术后听力的影响  

Analysis of factors affecting hearing after canal wall-down tympanoplasty for chronic suppurative otitis media

作　　者：陈敏芬[1] 潘兆虎[1] 徐锦[2] CHEN Min-fen;PAN Zhao-hu;XU Jin(Department of Otorhinolaryngology,Taizhou hospital,Linhai,Zhejiang 317000,China;不详)

机构地区：[1]浙江省台州医院耳鼻咽喉科,浙江临海317000 [2]浙江省立同德医院耳鼻喉科,浙江杭州310012

出　　处：《中华全科医学》2020年第5期773-775,820,共4页Chinese Journal of General Practice

基　　金：2018年度浙江省中医药科技计划项目(2018ZT002)。

摘　　要：目的探讨开放式鼓室成形术治疗慢性化脓性中耳炎(choronic suppurative otitis media,CSOM)时影响术后听力的因素。方法选取2015年10月-2017年10月浙江省台州医院收治的86例CSOM患者为研究对象,所有患者均行开放式鼓室成形术,比较术前1周和术后6个月的气导听阈(air conduction,AC)、骨导听阈(bone conduction,BC)和气骨导差(air-bone gap,ABG),分析术中可能影响听力的相关因素,并通过logistic回归分析,找出开放式鼓室成形术治疗CSOM时对听力造成影响的因素。结果术前1周和术后6个月的AC[(65.73±8.25)dB vs.(47.52±6.82)dB]、ABG[(30.60±3.20)dB vs.(11.50±2.11)dB]比较差异具有统计学意义(t=15.777、45.122;均P<0.001)。镫骨及镫骨底板未破坏者的AC优于镫骨或镫骨底板破坏者,后鼓室开放者的AC优于后鼓室未开放者(χ^2=8.010、7.668;P=0.018、0.022)。镫骨或镫骨底板是否破坏、后鼓室是否开放是影响术后听力的独立因素(P=0.011、0.014)。结论开放式鼓室成形术对于改善CSOM患者术后听力具有一定作用,术中保留镫骨及镫骨底板的完好及开放后鼓室是影响术后听力较为重要的因素。Objective To investigate the factors affecting postoperative hearing in canal wall-down tympanoplasty for chronic septic otitis media(CSOM).Methods Eighty-six patients with CSOM admitted to our hospital from October 2015 to October 2017 were enrolled,who were treated with canal wall-down tympanoplasty The air conduction(AC),Bone conduction threshold(BC)and air-bone gap(ABG)between 1 week before and 6 months after surgery were compared.In addition,the relevant factors that may affect the hearing during surgery were collected.Logistic regression analysis was performed to find out the factors affecting hearing in open tympanoplasty.Results The difference of AC[(65.73±8.25)dB vs.(47.52±6.82)dB]and ABG ABG[(30.60±3.20)dB vs.(11.50±2.11)dB]between 1 week and 6 months after operation was statistically significant(t=15.777,45.122;P<0.001).The AC of the humerus or humerus floor not destroyed was better than that of destroyed.The AC of posterior tympanic opened was better than that of not opened(χ^2=8.010,7.668;P=0.018,0.022).Whether the humerus or tibial floor was damaged or whether the posterior tympanic cavity was open were the independent factors affecting postoperative hearing in open tympanoplasty for CSOM(P=0.011,0.014).Conclusion Open tympanoplasty has a certain effect on improving postoperative hearing in CSOM patients.Preserving the integrity of the humerus or tibial floor during operation and the open tympanic cavity are important factors influencing postoperative hearing.

关 键 词：开放式鼓室成形术 慢性化脓性中耳炎 听力 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R764.92[医药卫生—临床医学]