内镜下与显微镜下行耳屏软骨-软骨膜鼓膜修补术治疗鼓膜穿孔患者的效果比较  

Comparison of effects of endoscopic and microscopic tragus cartilage-perichondrium repair in treatment of patients with tympanic membrane perforation

作　　者：常加锋 CHANG Jiafeng(Department of Ophthalmology and Otolaryngology of 83rd Group Army Hospital of the People’s Liberation Army,Xinxiang 453000 Henan,China)

机构地区：[1]解放军陆军第八十三集团军医院眼耳鼻喉科,河南新乡453000

出　　处：《中国民康医学》2022年第10期74-77,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较内镜下与显微镜下行耳屏软骨-软骨膜鼓膜修补术治疗鼓膜穿孔患者的效果。方法:选取120例鼓膜穿孔患者为研究对象,采用随机数字表法分为对照组与研究组各60例。对照组行显微镜下耳屏软骨-软骨膜鼓膜修补术治疗,研究组行内镜下耳屏软骨-软骨膜鼓膜修补术治疗,比较两组围术期指标(手术时间、术中出血量和住院时间)水平,手术前后气骨导差、气导听阈,术后1个月内并发症发生率,以及随访6个月复发率。结果:研究组术中出血量少于对照组,手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后6个月,研究组气骨导差和气导听阈均低于对照组,差异有统计学意义(P<0.05);研究组术后并发症发生率为6.67%(4/60),低于对照组的20.00%(12/60),差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。结论:内镜下行耳屏软骨-软骨膜鼓膜修补术治疗鼓膜穿孔患者可改善围术期指标水平,降低气骨导差、气导听阈和术后并发症发生率,效果优于显微镜下行耳屏软骨-软骨膜鼓膜修补术治疗。Objective:To compare effects of endoscopic and microscopic tragus cartilage-perichondrium repair in treatment of patients with tympanic membrane perforation.Methods:120 patients with tympanic membrane perforation were selected as the research objects and were divided into control group and study group by using the random number table method,60 cases in each group.The control group was treated with microscopic tragus cartilage-perichondrium repair,while the study group was treated with endoscopic tragus cartilage-perichondrium repair.The levels of the perioperative indicators(operation time,intraoperative blood loss,hospitalization time),the air-bone conduction difference before and after the surgery,the air-conduction audiometry threshold,the incidence of complications within 1 month after the surgery and the recurrence rate during 6-month follow-up were compared between the two groups.Results:The intraoperative blood loss in the study group was less than that in the control group;the operation time and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).6 months after the surgery,the air-bone conduction difference and the air-conduction hearing threshold of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was 6.67%(4/60),which was lower than 20.00%(12/60)in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusions:Endoscopic tragus cartilage-perichondrium repair in the treatment of the patients with tympanic membrane perforation can improve the perioperative indicator levels and reduce the air-bone conduction difference,the air-conduction hearing threshold and the postoperative incidence of complications.Moreover,it is superior to microscopic tragus cartilage-perichondrium repair.

关 键 词：鼓膜穿孔 耳屏软骨-软骨膜鼓膜修补术 显微镜 耳内镜 气导 听阈 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]