干湿耳状态下耳内镜下耳屏软骨-软骨膜Ⅰ型鼓室成形术远期疗效比较  

Comparison of the long-term efficacy of tragal cartilage-perichondrium type I tympanoplasty under ear endoscopy between wet and dry ears

作　　者：黄献明 覃雪君 谭宇敏 HUANG Xian-Ming;QIN Xue-Jun;TAN Yu-min(Hechi First People's Hospital,Hechi 546300,China)

机构地区：[1]广西壮族自治区河池市第一人民医院,广西河池546300

出　　处：《实用医院临床杂志》2024年第5期157-160,共4页Practical Journal of Clinical Medicine

基　　金：广西河池市科技计划项目(编号:AB193621)。

摘　　要：目的比较分析干湿耳状态下耳内镜下耳屏软骨-软骨膜Ⅰ型鼓室成形术远期疗效。方法选取2018年1月至2019年1月在我院就诊的90例慢性化脓性中耳炎患者,其中干耳组50例、湿耳组40例。两组均在耳内镜下行耳屏软骨-软骨膜Ⅰ型鼓室成形术治疗,比较两组术后鼓膜愈合、并发症发生情况、手术前后气导与骨气导变化情况及复发情况。结果干耳组、湿耳组鼓膜愈合率分别为98.0%、95.0%,差异无统计学意义(P>0.05)。两组术后气导较术前明显提高,骨气导差较术前明显下降,差异有统计学意义(P<0.05);术后6月、术后1年、术后2年优于术前(P<0.05),术后3年与术后2年比较,差异无统计学意义(P>0.05)。两组间术后气导及骨气导差比较,差异无统计学意义(P>0.05)。两组术后并发症及复发率比较,差异均无统计学意义(P>0.05)。结论在干耳与湿耳状态下耳内镜下耳屏软骨-软骨膜I型鼓室成形术均可有效修复鼓膜,无明显并发症,且均远期听力疗效稳定,复发率均较低。Objective To compare and analyze the long-term effect of tragal cartilage-perichondrium type I tympanoplasty under ear endoscope between dry and wet ear conditions.Methods Ninety patients with chronic suppurative otitis media admitted to our hospital from January 2018 to January 2019 were selected.They were divided into a dry ear group(n=50)and a wet ear group(n=40).Both groups were treated with tragal cartilage-perichondrium type I tympanoplasty under ear endoscopy.Postoperative healing of tympanic membrane,occurrence of complications,changes of air permeability and bone air permeability before and after surgery,and recurrence rate were compared between the two groups.Results The healing rate of eardrum in the dry ear group was 98.00%,which was not significantly different from 95.00%in the wet ear group(P>0.05).The postoperative air permeability was significantly increased while bone air permeability was significantly decreased in both groups.The differences were statistically significant(P<0.05).After 6 months,1 year and 2 years of surgery,gradual improvement was significant when compared with before surgery(P<0.05).There was no significant difference between 3 years after surgery and 2 years after surgery(P>0.05).There were no significant differences in postoperative air permeability and bone air permeability between the two groups(P>0.05).There was no statistically significant difference in the postoperative complications and recurrence rates between the two groups(P>0.05).Conclusions The tympanoplasty under ear endoscope between dry ear and wet ear can effectively repair the tympanic membrane without obvious complications.The long-term hearing effect is stable and the recurrence rate is low in both cases.

关 键 词：干耳 湿耳 耳屏软骨-软骨膜 Ⅰ型鼓室成形术 鼓膜修复 远期疗效 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]