湿耳条件下耳内镜鼓膜修补术对慢性化脓性中耳炎患者听力及咽鼓管功能的影响  

Effect of otoscope tympanic membrane repair under wet ear condition on hearing and eustachian tube function in patients with chronic suppurative otitis media

作　　者：王忠勋 刘勇[1] 李超[1] 曹永华 Wang Zhongxun;Liu Yong;Li Chao;Cao Yonghua(Department of Otolaryngology,the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第二附属医院耳鼻喉科,咸阳712000

出　　处：《山西医药杂志》2021年第23期3235-3238,共4页Shanxi Medical Journal

基　　金：陕西中医药大学第二附属医院院级学科创新团队建设项目(2020XKTD-C05)。

摘　　要：目的研究湿耳条件下耳内镜鼓膜修补术对慢性化脓性中耳炎(CSOM)患者听力及咽鼓管功能的影响。方法纳入陕西中医药大学第二附属医院收治的CSOM患者154例,根据术前是否为湿耳状态,分为湿耳组(47例)和对照组(107例)。2组均行耳内镜鼓膜修补术。比较2组术后6个月的鼓膜愈合率、干耳率以及干耳时间。比较2组术前和术后6个月的听力情况、咽鼓管功能以及耳鸣分级。结果对照组和湿耳组的鼓膜愈合率、干耳率以及干耳时间比较,差异均无统计学意义(P>0.05)。术后6个月,2组的气导、骨导、气骨导差比较,差异均无统计学意义(P>0.05)。术前,对照组的咽鼓管功能良好率明显高于湿耳组(P<0.05)。术后6个月,2组的咽鼓管功能良好率均明显提高(P<0.05),其中对照组和湿耳组的咽鼓管功能良好率,差异无统计学意义(P>0.05)。术后6个月,2组的耳鸣分级均明显改善(P<0.05)。术前和术后6个月2组的耳鸣分级比较,差异均无统计学意义(P>0.05)。结论湿耳和干耳条件下对CSOM患者开展耳内镜下鼓膜修补术的疗效满意,均可有效促使患者听力的恢复,以及咽鼓管功能和耳鸣的改善。Objective To evluate the effects of endoscopic tympanic membrane repair under wet ear conditions on the hearing and eustachian tube function of patients with chronic suppurative otitis media(CSOM).Methods A total of 154 CSOM patients admitted to the Second Affiliated Hospital of Shaanxi Traditional Chinese Medicine University were divided into wet ear group(47 cases)and control group(107 cases)according to whether they were wet ears before operation.Both groups underwent ear endoscopic tympanic membrane repair.The tympanic membrane healing rate,dry ear rate and dry ear time were compared between the two groups at 6 months after operation.Hearing,eustachian tube function and tinnitus grade were compared between the two groups before and 6 months after operation.Results There was no statistically significant difference between the tympanic membrane healing rate,dry ear rate and was ear time between the control group and the wet ear group(P>0.05).Six months after operation,there was no significant difference in air conduction,bone conduction and air-bone conduction between the two groups(P>0.05).Before surgery,the rate of good eustachian tube function in the control group was significantly higher than that in the wet ear group(P<0.05).At 6 months after operation,the rate of good eustachian tube function in the two groups was significantly improved(P<0.05).There was no significant difference in the rate of good eustachian tube function between the control group and wet ear group(P>0.05).At 6 months after operation,the tinnitus grading of the two groups was significantly improved(P<0.05).No difference in the tinnitus grading between the two groups before and 6 months after the operationwere was found(P>0.05).Conclusion Endoscopic tympanoplasty for CSOM patients under wet and dry ear conditions is satisfactory,which can effectively promote the recovery of patients′hearing and improve eustachian tube function and tinnitus.

关 键 词：中耳炎 化脓性 耳鸣 咽鼓管 听力 湿耳 耳内镜 鼓膜修补术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]