耳内镜下鼓膜修补术治疗慢性化脓性中耳炎鼓膜穿孔患者的临床疗效分析  

Clinical efficacy of endoscopic tympanic membrane repair in the treatment of chronic suppurative otitis media with tympanic membrane perforation

作　　者：刘艳娟[1] LIU Yan-juan(Department of Otolaryngology,Tieling Central Hospital,Tieling 112000,China)

机构地区：[1]铁岭市中心医院耳鼻喉科,112000

出　　处：《中国实用医药》2022年第15期28-31,共4页China Practical Medicine

摘　　要：目的 分析耳内镜下鼓膜修补术治疗慢性化脓性中耳炎鼓膜穿孔患者的临床疗效。方法 88例慢性化脓性中耳炎鼓膜穿孔患者,按随机数字表法分为耳内镜组和显微镜组,各44例。显微镜组予以显微镜下鼓膜修补术治疗,耳内镜组予以耳内镜下鼓膜修补术治疗。对比两组围术期情况、术前及术后6 h的视觉疼痛模拟评分(VAS)评分、术前及术后3个月的纯音听阈、并发症发生率。结果 耳内镜组手术时间(57.53±6.47)min、住院时间(4.91±1.27)d均短于显微镜组的(91.65±9.59)min、(9.20±2.76)d,术中失血量(6.63±1.98)ml少于显微镜组的(13.94±3.62)ml,差异有统计学意义(P<0.05)。术后6 h,耳内镜组VAS评分(1.79±0.46)分低于显微镜组的(2.35±0.62)分,差异有统计学意义(P<0.05)。术后3个月,耳内镜组气骨导差(10.14±3.19)dB、气导听阈(25.81±4.43)kHz均低于显微镜组的(12.57±3.36)dB、(28.50±4.67)kHz,差异有统计学意义(P<0.05)。耳内镜组并发症发生率4.55%低于显微镜组的22.73%,差异有统计学意义(P<0.05)。结论 耳内镜下鼓膜修补术治疗慢性化脓性中耳炎鼓膜穿孔患者,可缩短手术时间,减少术中失血量,减轻术后疼痛,降低并发症发生率,改善患者听敏度,加快康复进程。Objective To analyze the clinical efficacy of endoscopic tympanic membrane repair in the treatment of chronic suppurative otitis media with tympanic membrane perforation.Methods A total of 88 patients with chronic suppurative otitis media and tympanic membrane perforation were divided into endoscope group and microscope group according to the random numerical table,with 44 cases in each group.The microscope group was treated with microscopic tympanic membrane repair,and the endoscope group was treated with endoscopic tympanic membrane repair.Both groups were compared in terms of perioperative conditions,visual analogue scale(VAS)scores before and 6 h after surgery,pure-tone thresholds before and 3 months after surgery,and the complication rate.Results The operation time(57.53±6.47)min and hospitalization time(4.91±1.27)d in the endoscope group were shorter than(91.65±9.59)min and(9.20±2.76)d in the microscope group,and the intraoperative blood loss(6.63±1.98)ml was less than(13.94±3.62)of the microscope group.All the differences were statistically significant(P<0.05).At 6 h after surgery,the VAS score(1.79±0.46)points of the endoscope group was lower than(2.35±0.62)points of the microscope group,and the difference was statistically significant(P<0.05).At 3 months after surgery,the air-bone gap(10.14±3.19)dB and the air conduction threshold(25.81±4.43)kHz in the endoscope group were lower than(12.57±3.36)dB and(28.50±4.67)kHz in the microscope group,and the differences were statistically significant(P<0.05).The complication rate 4.55%in the endoscope group was lower than 22.73%in the microscope group,and the difference was statistically significant(P<0.05).Conclusion Endoscopic tympanic membrane repair for patients with chronic suppurative otitis media and tympanic membrane perforation can shorten the operation time,reduce intraoperative blood loss,relieve postoperative pain,reduce the complication rate,improve hearing sensitivity,and speed up the rehabilitation process.

关 键 词：慢性化脓性中耳炎鼓膜穿孔 显微镜下鼓膜修补术 耳内镜下鼓膜修补术 纯音听阈 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]