微创鼓膜成形术对慢性化脓性中耳炎患者应激反应及听力恢复的影响  

Effect of minimally invasive myringoplasty on stress response and hearing recovery in patients with chronic suppurative otitis media

作　　者：黄从波 徐忠华 郑泉山 Huang Congbo;Xu Zhonghua;Zheng Quanshan(Jiangxi Yingtan 184th Hospital,Yingtan,Jiangxi 335000,China)

机构地区：[1]江西鹰潭一八四医院,江西鹰潭335000

出　　处：《首都食品与医药》2024年第22期50-52,共3页Capital Food Medicine

摘　　要：目的 探讨微创鼓膜成形术在慢性化脓性中耳炎(CSOM)患者中的应用效果.方法 选取2020年4月-2023年4月我院收治的96例CSOM患者,按随机数字表法分为两组,每组各48例.对照组行传统开放鼓室成形术,观察组采用微创鼓膜成形术,持续随访3个月.对比两组手术相关指标、应激反应、听力恢复情况及并发症发生率.结果 观察组手术时间(48.63±6.27)min、住院时间(3.95±0.58)d,短于对照组的(60.33±8.15)min、(5.12±0.87)d,术中出血量(6.70±1.55)ml,低于对照组的(8.06±1.69)ml(P<0.05);术前两组应激反应、听力比较,差异不显著(P>0.05);术后24h,观察组促肾上腺皮质激素(ACTH)水平(12.32±1.70)pg/ml、皮质醇(COR)水平(19.36±1.61)μg/ml、去甲肾上腺素(NE)水平(66.22±6.03)ng/ml、舒张压(DBP)水平(90.84±7.55)mmHg、收缩压(SBP)水平(106.75±9.81)mmHg、术后3个月听力数值(18.99±2.67),低于对照组的(15.21±2.23)pg/ml、(23.05±2.21)μg/ml、(74.82±6.95)ng/ml、(102.26±8.85)mmHg、(118.77±11.45)mmHg、(24.05±3.12);观察组并发症发生率为4.16%,低于对照组的18.75%(P<0.05).结论 与传统开放手术相比,微创鼓膜成形术在CSOM患者中治疗效果更显著,生理应激更轻,术后并发症少,且听力恢复更佳.Objective To investigate the effect of minimally invasive myringoplasty in patients with chronic suppurative otitis media(CSOM).Methods 96 patients with CSOM admitted to our hospital from April 2020 to April 2023 were selected and divided into two groups according to random number table method,48 cases in each group.The control group underwent traditional open tympanoplasty,the observation group underwent minimally invasive tympanoplasty,and the follow-up was continued for 3 months.The operation related indexes,stress response,hearing recovery and complication rate of the two groups were compared.Results The operation time and hospitalization time of the observation group were(48.63±6.27)min and(3.95±0.58)d,which were shorter than those of the control group(60.33±8.15)min and(5.12±0.87)d,and the intraoperative blood loss was(6.70±1.55)ml,it was lower than that of control group(8.06±1.69)ml(P<0.05);the stress response and hearing of the two groups were compared before surgery(P>0.05),24 hours after surgery,the adrenocorticotropic hormone(ACTH)level was(12.32±1.70)pg/ml,cortisol(COR)level was(19.36±1.61)μg/ml,norepinephrine(NE)level was(66.22±6.03)ng/ml and diastolic blood pressure(DBP)level was(90.84±7.55)mmHg in the observation group,systolic blood pressure(SBP)level(106.75±9.81)mmHg,hearing value 3 months after surgery(18.99±2.67),lower than control group(15.21±2.23)pg/ml,(23.05±2.21)μg/ml,(74.82±6.95)ng/ml,(102.26±8.85)mmHg,(118.77±11.45)mmHg,(24.05±3.12);the complication rate of 4.16%in the observation group was lower than that of control group(18.75%)(P<0.05).Conclusion Compared with traditional open surgery,minimally invasive myringoplasty is more effective in CSOM patients,with less physiological stress,fewer postoperative complications,and better hearing recovery.

关 键 词：慢性化脓性中耳炎 微创鼓膜成形术 应激反应 听力 并发症 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]