持续灌流模式内镜与显微镜治疗上鼓室胆脂瘤:一项随机对照试验  

Endoscopic Surgery in Continuous Irrigating Mode and Traditional Microscopic Surgery for the Attic Cholesteatoma:A Randomized Controlled Trial

作　　者：张旭[1] 严齐 徐丽[2] 焦成 陈丽[1] 关兵[2] ZHANG Xu;YAN Qi;XU Li;JIAO Cheng;CHEN Li;GUAN Bing(Yangzhou Clinical Medical College,Dalian Medical University,Dalian 116000,China;不详)

机构地区：[1]大连医科大学扬州临床医学院,大连116000 [2]扬州大学医学院附属苏北人民医院

出　　处：《中华耳科学杂志》2024年第2期196-200,共5页Chinese Journal of Otology

摘　　要：目的 比较持续灌流模式内镜手术(continuous irrigating mode for endoscopic ear surgery,CIM-EES)与显微镜手术(microscopic ear surgery,MES)治疗上鼓室胆脂瘤的疗效。方法 选取2021年8月—2022年3月扬州大学临床医学院耳鼻咽喉头颈外科收治的72例上鼓室胆脂瘤患者,采取随机数表法分为CIM-EES组36例和MES组36例。CIM-EES组采用CIM-EES治疗,MES组采用显微镜下耳内入路手术治疗。比较两组术中中耳结构可见度指数(middle ear structural visibility index,MESVI)、手术时间、术后疼痛、手术治疗效果。结果 术中,CIM-EES组MESVI评分低于MES组,差异有统计学意义(P<0.01);CIM-EES组手术时间短于MES组,差异有统计学意义(P<0.01);术后,CIM-EES组疼痛评分低于MES组,差异有统计学意义(P<0.01);两组治疗效果比较,差异无统计学意义(P>0.05)。结论 CIM-EES治疗上鼓室胆脂瘤相比MES有明显优势,术中可视化更好、术中磨骨量更少、术中视野持续清晰、手术时间更短、患者术后痛苦更小、术后并发症发生率更低。Objective This study aims to compare continuous irrigating mode for endoscopic ear surgery(CIMEES)and traditional microscopic ear surgery(MES)for treating attic cholesteatoma.Methods 72 patients diagnosed with attic cholesteatoma admitted to the Department of Otolaryngology-Head and Neck Surgery,School of Clinical Medicine,Yangzhou University from August 2021 to March 2022 were selected and divided into CIM-EES and MES groups by the random number table method.Patients in the CIM-EES group were treated with continuous irrigating mode endoscopic surgery,and patients in the MES group were treated with transcanal microscopic surgery.The intraoperative middle ear structural visibility index(MESVI),operative time,postoperative pain condition and surgical treatment effect were compared between the two groups.Results The intraoperative MESVI score of CIM-EES group was lower than that of MES group,the difference was statistically significant(P<0.001);the operative time was shorter than that of MES group,the difference was statistically significant(P<0.01);the postoperative pain score was lower than that of MES group,the difference was statistically significant(P<0.01);the surgical effect of the CIM-EES group was compared with that of the MES group,the differences were not statistically significant(P>0.05).Conclusion CIM-EES for treating attic cholesteatoma has substantial advantages over MES,including better intraoperative visualization,less intraoperative bone grinding,continuous clear intraoperative visualization,shorter operative time,less postoperative pain for patients,and lower incidence of postoperative complications.

关 键 词：耳内镜 持续灌流模式 上鼓室胆脂瘤 显微镜 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]