耳内镜下听骨链重建术在治疗慢性中耳炎中的临床应用价值  

Clinical Application Value of Endoscopic Ossicular Chain Reconstruction in the Treatment of Chronic Otitis Media

作　　者：李健[1] 苏云缈 韦忠善 卢宣桦[1] 覃佳 吴曾权 韦秀娇 LI Jian;SU Yun-miao;WEI Zhong-shan;LU Xuan-hua;QIN Jia;WU Zeng-quan;WEI Xiu-jiao(Hechi People's Hospital,Guangxi Hechi 547000)

机构地区：[1]河池市人民医院,广西河池547000

出　　处：《深圳中西医结合杂志》2023年第11期25-28,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河池市科技计划项目(AB200706)。

摘　　要：目的:研究耳内镜下听骨链重建术在治疗慢性中耳炎中的临床应用价值。方法:选取河池市人民医院2020年7月至2021年7月收治的60例慢性中耳炎患者,根据不同治疗方法分为对照组和观察组,各30例。对照组患者行改良乳突根治术联合鼓室成形术治疗,观察组患者采用耳内镜下听骨链重建术治疗。比较两组患者临床疗效、手术相关指标、听力学指标[气导听力阈值(AC)、骨导听力阈值(BC)、气骨导差(ABG)]及生活质量[汉化版苏黎世慢性中耳炎量表(ZCMEI)评分],比较两组患者并发症发生率。结果:两组患者临床总有效率比较,差异无统计学意义(P>0.05)。观察组患者术后干耳率、听力改善率均高于对照组,干耳时间短于对照组、鼓膜穿孔率低于对照组,差异具有统计学意义(P<0.05)。术后60 d,两组患者AC、ABG均低于术前,且观察组患者AC、ABG均低于对照组,差异具有统计学意义(P<0.05)。观察组患者并发症发生率低于对照组,差异具有统计学意义(P<0.05)。术后60 d,两组患者中耳炎症状、社会心理影响、主观听力水平、医疗资源使用评分及ZCMEI总分均低于术前,且观察组患者低于对照组,差异具有统计学意义(P<0.05)。结论:耳内镜下听骨链重建术用于慢性中耳炎患者治疗中疗效显著,可促进患者听力恢复,缩短干耳时间。Objective To study the clinical application value of endoscopic ossicular chain reconstruction in the treatment of chronic otitis media.Methods Sixty patients with chronic otitis media treated in Hechi People's Hospital from July 2020 to July 2021 were selected and divided into a control group and an observation group according to different treatment methods,with 30 cases in each group.The control group was treated with modified mastoidectomy combined with tympanoplasty,and the observation group was treated with endoscopic ossicular chain reconstruction.The clinical efficacy,surgical related indexes,audiological indexes[air conduction(AC),bone conduction(BC),air-bone gap(ABG)]and quality of life[Zurich chronic otitis media scale(ZCMEI)]were compared between the two groups,and the incidence of complications was compared between the two groups.Results There was no significant difference in clinical total effective rate between the two groups(P>0.05).Dry ear rate and hearing improvement rate of the observation group were higher than those of the control group,dry ear time was shorter than that of the control group,tympanic membrane perforation rate was lower than that of the control group,the differences were statistically significant(P<0.05).60 days after surgery,AC and ABG in the two groups were lower than thoset before surgery,and AC and ABG in the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).60 days after surgery,the scores of symptoms of otitis media,psychosocial impact,subjective hearing level,medical resource use and ZCMEI total score of the two groups were lower than those before surgery,and the scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion Endoscopic ossicular chain reconstruction is effective in the t

关 键 词：慢性中耳炎 耳内镜 听骨链重建术 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]