耳内镜下两种不同手术入路治疗慢性化脓性中耳炎鼓膜穿孔的疗效差异及术后复发情况分析  

Analysis of the Difference inEfficacy and Postoperative Recurrence of Two Different Surgical Approaches under Otoendoscopy in the Treatment of Chronic Suppurative Otitis Media with Tympanic Membrane

作　　者：庄得才 郭世鸿[1] 张淑芳 高艳儒 张玉梅 李斌苗 戴九江 滕玉飞 ZHUANG Decai;GUO Shihong;ZHANG Shufang;GAO Yanru;ZHANG Yumei;LI Binmiao;DAI Jiujiang;TENG Yufei(The Second People’s Hospital of Lanzhou,Lanzhou 730046,Gansu,China)

机构地区：[1]兰州市第二人民医院,甘肃兰州730046

出　　处：《现代诊断与治疗》2024年第17期2532-2534,2544,共4页Modern Diagnosis and Treatment

基　　金：兰州市科技局项目(项目编号2022-5-137)。

摘　　要：目的 分析耳内镜下两种不同手术入路治疗慢性化脓性中耳炎鼓膜穿孔的疗效差异和术后复发情况。方法 选取2021年12月至2023年12月我院收治的慢性化脓性中耳炎鼓膜穿孔患者60例为研究对象,按照数字抽签法分为对照组与观察组各30例。观察组给予耳内镜下内衬法修复,对照组给予耳内镜下蝶形软骨膜嵌入术修复。采用丹麦Madsen电子公司Conera听力计检测两组患者治疗前、治疗3个月后气导听阈值与骨导听阈值,同时比较组间临床疗效、术后复发率。结果 观察组患者治疗有效率高于对照组,差异具有统计学意义(P<0.05);组间术后3周复发率无明显差异(P>0.05),术后1个月、3个月:观察组复发率低于对照组,差异具有统计学意义(P<0.05);组间治疗前听阀改善情况无统计学差异(P>0.05),治疗后组间听阀改善情况比较无统计学差异(P>0.05);两组患者治疗后不良反应发生率无统计学差异(P>0.05)。结论 耳内镜下内衬法与蝶形软骨膜嵌入术修复均能较好改善慢性化脓性中耳炎鼓膜穿孔患者听阀水平,但内衬法治疗总有效率更高,术后长期复发率更低,内衬法治疗综合应用价值更高。Objectives To analyze the difference of efficacy and postoperative recurrence of two different surgical approaches under otoendoscopy in the treatment of chronic suppurative otitis media tympanic membrane perforation.Methods A total of 60 patients with chronic suppurative otitis media tympanic membrane perforationadmitted to our hospital from December 2021 to December 2023 were selected as the research objects.The patients were randomly divided into control group andobservation groupby digital drawing method,with 30 cases in each group.The observation group underwent endoscopic tympanic membrane repair with inner lining method,and the control group was treated with butterfly shaped cartilage membrane embedding method under ear endoscopy.The air conduction hearing threshold and bone conduction hearing thresholdbefore and after three months of treatment were measured by the Conera audiometer of Denmark company Madsen Electronics,and the clinical efficacy and postoperative recurrence rate were compared between the two groups.Results The effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).There was no statistically significant difference in the three-week postoperative recurrence rate between the two groups(P>0.05).At one month and three months after surgery,the recurrence rate in the observation group was significantly lower than that in the control group(P<0.05).There was no statistically significant difference in the improvement of hearing valves between the two groups before treatment(P>0.05),and there was no statistically significant difference in the improvement of hearing valves between the two groups after treatment(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups after treatment(P>0.05).Conclusions Both the inner lining method and the butterfly shaped cartilage membrane embedding surgery under ear endoscopy can effectively improve the hearing valve level in patients with chronic suppurativ

关 键 词：内衬法修复 蝶形软骨膜嵌入术修复 慢性化脓性中耳炎 鼓膜穿孔 复发率 

分 类 号：R541.6[医药卫生—心血管疾病]