耳内镜技术针对早期中耳胆脂瘤手术患者的治疗效果  

Surgical Treatment Effect of Early Middle Ear Cholesteatoma by Ear Endoscopy

作　　者：熊斌 曾琼芳 赖文敏 张小安 XIONG Bin;ZENG Qiongfang;LAI Wenmin;ZHANG Xiaoan(Ganzhou Hospital,Guangdong Provincial People's Hospital,Ganzhou 341000,China;Ganzhou Longnan Maternal and Child Health Hospital,Ganzhou 341000,China)

机构地区：[1]广东省人民医院赣州医院,江西赣州341000 [2]赣州市龙南县妇幼保健院,江西赣州341000

出　　处：《中国医药指南》2022年第20期66-69,共4页Guide of China Medicine

摘　　要：目的探讨耳内镜技术在早期中耳胆脂瘤手术患者中的治疗效果。方法选择2019年4月至2021年10月广东省人民医院赣州医院收治的早期中耳胆脂瘤患者53例为对象,根据手术方法分为对照组(28例)和观察组(25例)。对照组采用显微镜手术治疗,观察组采用耳内镜技术治疗,术后12 d评估两组患者的效果,并对患者进行12个月的门诊随访,比较两组手术指标、生化指标、纯音测听、视觉模拟量表(VAS)评分、术后并发症发生情况及复发率。结果观察组鼓膜愈合时间、炎症吸收时间及住院时间均短于对照组(P<0.05);观察组手术12 d后PON1、SOD水平高于对照组(P<0.05),hs-CRP、MDA水平低于对照组(P<0.05);观察组手术后1、3、6、12 d的VAS评分均低于对照组(P<0.05);两组围手术期脑脊液漏、鼓膜穿孔及味觉改变并发症发生率比较,差异无统计学意义(P>0.05);观察组术后12个月复发率低于对照组(P<0.05)。结论耳内镜技术用于早期中耳胆脂瘤患者中,有助于减少手术创伤,改善患者生化指标水平,减轻患者疼痛程度,降低远期复发率。Objective To investigate the therapeutic effect of otoendoscopy in early middle ear cholesteatoma patients.Methods Fiftythree patients with early middle ear cholesteatoma from April 2019 to October 2021 were selected as subjects,and divided into control group(28 cases)and observation group(25 cases)according to surgical methods.The control group was treated with microscope surgery,and the observation group was treated with otoscopy.The outcomes of the patients were evaluated 12 days after surgery,and the patients were followed up for 12 months in the outpatient department.The surgical indicators,biochemical indicators,pure tone audiometry,visual analogue pain(VAS)score,postoperative complications and recurrence rates of the two groups were compared.Results The healing,inflammatory absorption and hospitalization time of eardrum in observation group were shorter than those in control group(P<0.05).The levels of PON1 and SOD in observation group were higher than those in control group 12 days after operation(P<0.05).The levels of HS-CRP and MDA in observation group were lower than those of control group(P<0.05).The VAS scores of observation group were lower than control group at 1,3,6,12 d after operation(P<0.05).There was no statistical significance in the incidence of cerebrospinal fluid leakage,tympanic membrane perforation and taste change between the two groups(P>0.05).The recurrence rate of the observation group 12 months after operation was lower than that of the control group(P<0.05).Conclusion The application of otoendoscopy in early middle ear cholesteatoma patients can help reduce surgical trauma,improve the level of biochemical indicators,relieve pain,and reduce the long-term recurrence rate,which is worthy of popularization and application.

关 键 词：中耳胆脂瘤 耳内镜技术 显微镜手术 生化指标 复发 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]