脱细胞真皮基质与耳屏软骨-软骨膜修补鼓膜的临床对比研究  

Comparison of the cilinical efficacy on eardrum repair with acellular dermal allograft and tragus cartilage perichondrium

作　　者：谭志强[1] 刘映辰 彭韬 苗刚勇[1] 周恩[1] 肖旭平[1] 刘斌[1] TAN Zhiqiang;LIU Yingchen;PENG Tao;MIAO Gangyong;ZHOU En;XIAO Xuping;LIU Bin(Department of Otolaiyngology Head and Neck Surgeiy,Hunan Provincial People's Hospital(First Affiliated Hospital of Hunan Normal University),Changsha,Hunan,410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学第一附属医院)耳鼻咽喉头颈外科,湖南长沙410005

出　　处：《中国耳鼻咽喉头颈外科》2021年第5期281-284,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：湖南省科技创新引导计划-临床医疗技术创新引导项目(2018SK50705);国家自然科学青年项目(81800921)。

摘　　要：目的对比脱细胞真皮基质(acellular dermal matrix,ADM)与耳屏软骨-软骨膜(tragus cartilage-perichondrium,TCP)在鼓膜修补中的临床疗效。方法60例慢性化脓性中耳炎患者随机分成两组,每组各30例。组1采用ADM作为鼓膜修补材料,组2采用TCP作为鼓膜修补材料。收集两组患者手术时间及术前、术后6个月的耳内镜、纯音测听(500、1000、2000、4000 Hz)结果,比较两组手术时间、鼓膜愈合率及听力情况的差别。结果组1的鼓膜穿孔愈合率86.67%(26/30),组2鼓膜穿孔愈合率93.33%(28/30),两组比较无统计学差异(P>0.05),两组术前平均气导听阈及气骨导差与术后6个月比较有统计学差异(P<0.05),两组间术前平均气导听阈[(47.43±10.45)dB vs(46.64±9.75)dB]、术前气骨导差[(17.94±3.04)dB vs(18.02±2.89)dB]、术后6个月气骨导差[(10.46±5.92)dB vs(10.12±2.54)dB]比较,无统计学意义(t=1.89、-0.62、1.92,P均>0.05)。组1手术时间明显短于组2[(40.51±5.46)min vs(58.86±4.29)min,χ^(2)=-88.93,P<0.05]。结论 ADM可作为鼓膜穿孔的修补材料,其愈合率及听力改善情况与TCP疗效类似,但可明显缩短手术时间。OBJECTIVE To compare the clinical efficacy of acellular dermal matrix(ADM) and tragus cartilage-perichondrium(TCP) in myringoplasty.METHODSSixty patients of chronic suppurative otitis media were randomly divided into two groups,the ADM group(group1)and the TCP group(group 2),each group included 30 cases.The clinical data were collected including otoscope image of eardrum,the results of average pure tone audiometry(PTA) in 500,1000,2000,4000 Hz frequency before operation and 6 months after operation and.The closure rate,hearing gain and operating time were compared between the two groups.RESULTS Successful closure rates were 86.67%(group 1) and 93.33%(group 2),there was no statistically significant difference(P>0.05).The difference between preoperative and postoperative 6 months of average PTA and air-bone gap(ABG)was statistically significant(P<0.05).The difference between preoperative and postoperative six months of average PTA and ABG were not statistically significant[(47.43±10.45)dB vs (46.64±9.75)dB;(17.94±3.04)dB vs (18.02±2.89)dB;(10.46±5.92)dB vs (10.12±2.54)dB;t=1.89,-0.62,1.92,P>0.05]between two groups.The operating time of group 1 was shorter than that of group 2[(40.51±5.46)min vs (58.86±4.29)min,χ^(2)=-88.93,P<0.05].CONCLUSION ADM could be used as repair material for tympanic membrane perforation,its closure rate and hearing gain was similar to that of TCP,but the operating time was greatly decreased.

关 键 词：内窥镜检查 鼓膜成形术 耳软骨 组织工程 耳内镜检查 耳屏软骨-软骨膜 

分 类 号：R764.9[医药卫生—耳鼻咽喉科] R318.08[医药卫生—临床医学]