耳内镜下蝶形软骨嵌入法与耳屏软骨膜内置法修补鼓膜中等穿孔的临床效果  

Clinical effect of butterfly cartilage embedding method and tragus perichondrium built-in method under otoendoscopy in repairing moderate perforation of tympanic membrane

作　　者：阮进松 RUAN Jinsong(Department of Otolaryngology Head and Neck Surgery,Zhejiang Provincial People's Hospital Bijie Hospital,Bijie,Guizhou 551700,China)

机构地区：[1]浙江省人民医院毕节医院耳鼻咽喉头颈外科,贵州毕节551700

出　　处：《医药前沿》2025年第8期44-46,50,共4页Journal of Frontiers of Medicine

摘　　要：目的观察耳内镜下蝶形软骨嵌入法与耳屏软骨膜内置法修补鼓膜中等穿孔的临床效果。方法回顾性分析2022年1月—2024年1月浙江省人民医院毕节医院收治的鼓膜中等穿孔患者128例,根据手术方式不同,将患者分成嵌入组(耳内镜下蝶形软骨嵌入法)65例、内置组(耳内镜下耳屏软骨膜内置法)63例。比较两组的围手术期指标,术前、术后听阈状况,临床疗效以及术后并发症发生情况。结果嵌入组手术时间长于内置组,治疗总有效率高于内置组,差异有统计学意义(P<0.05);两组术中出血量、术后住院时间及术后并发症总发生率比较,差异无统计学意义(P>0.05);术后3个月,两组平均气骨导差和平均气导听阈均降低,且嵌入组低于内置组,差异有统计学意义(P<0.05)。结论耳内镜下蝶形软骨嵌入法和耳屏软骨膜内置法修补鼓膜中等穿孔均可取得一定的效果,采用耳内镜下蝶形软骨嵌入法能够更好地改善听阈状况且治疗总有效率较高,内置法虽然手术时间较短、但其仍有一定治疗效果,且2种方法的安全性相当,可根据患者具体情况选择适合的手术方式。Objective To observe the clinical effect of butterfly cartilage embedding method and tragus perichondrium embedding method under otoendoscopy in repairing moderate perforation of tympanic membrane.Methods A total of 128 patients with moderate tympanic membrane perforation admitted to Zhejiang Provincial People's Hospital Bijie Hospital from January 2022 to January 2024 were retrospectively analyzed,according to the different surgical methods adopted by the patients,they were divided into the embedding group(butterfly cartilage embedding method under otoendoscope)65 cases and the built-in group(tragus perichondrium built-in method under otoendoscope)63 cases.The perioperative indexes,hearing threshold before and after operation,clinical efficacy and postoperative complications were compared between the two groups.Results The operation time of the embedding group was longer than that of the built-in group,and the total effective rate of treatment was higher than that of the built-in group,the differences were statistically significant(P<0.05);there was no significant difference in intraoperative blood loss,postoperative hospital stay and total incidence of postoperative complications between the two groups(P>0.05);at 3 months after operation,the mean air-bone gap and mean air-conduction hearing threshold of the two groups decreased,and those in the embedded group were lower than the built-in group,the differences were statistically significant(P<0.05).Conclusions For moderate perforation of tympanic membrane,butterfly cartilage embedding method and tragus perichondrium built-in method under otoendoscopy can achieve certain results,among them,the butterfly cartilage embedding method can better improve the hearing threshold,and the total effective rate of treatment is higher,although the tragus perichondrium built-in method has a short operation time,but it still has acertain therapeutic effect,and the safety of the two methods is comparable,the appropriate surgical method can be selected according to the specific co

关 键 词：鼓膜中等穿孔 耳内镜 蝶形软骨嵌入法 耳屏软骨膜内置法 听阈 

分 类 号：R681[医药卫生—骨科学]