内镜下传音机构重建术与显微镜下鼓室成形术治疗慢性中耳炎的效果比较  

Comparison of the Efficacy of Endoscopic Reconstruction of Sound Transmission Mechanism and Microscopic Tympanoplasty in the Treatment of Chronic Otitis Media

作　　者：胡云磊 张瑞芹 徐聪 HU Yunlei;ZHANG Ruiqin;XU Cong(Otolaryngology Department,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院耳鼻喉科,河南信阳464000

出　　处：《河南医学研究》2025年第7期1267-1271,共5页Henan Medical Research

摘　　要：目的探究比较内镜下传音机构重建术与显微镜下鼓室成形术治疗慢性中耳炎的疗效与安全性。方法前瞻性选取2020年9月至2023年9月信阳市中心医院收治的62例慢性中耳炎患者为研究对象,按照随机数字表法分为研究组与对照组,各30例。对照组接受显微镜下鼓室成形术治疗,研究组接受内镜下传音机构重建术治疗,比较两组疗效相关指标、听力学指标[骨导听力阈值(BC)、气导听力阈值(AC)、气骨导差(ABG)]、并发症、生活质量[苏黎世慢性中耳炎量表(ZCMEI)]的差异。结果等级资料秩和检验结果显示,两组疗效比较,差异有统计学意义(P<0.05),且研究组总有效率、听力改善率均高于对照组,鼓膜穿孔率、干耳率低于对照组(P<0.05)。两组治疗后ABG、AC均低于治疗前(P<0.05);且研究组治疗后ABG、AC均优于对照组(P<0.05),但两组治疗后BC比较,差异无统计学意义(P>0.05)。两组感染发生率、鼓膜内陷发生率、眩晕发生率、耳鸣发生率比较,差异无统计学意义(P>0.05),但研究组患者总并发症发生率低于对照组(10.00%比33.33%)(P<0.05)。两组治疗后医疗资料使用评分、中耳炎症状评分、主观听力水平评分、社会心理影响评分、ZCMEI总分均低于治疗前(P<0.05);且研究组治疗后ZCMEI各项条目得分与总分均低于对照组(P<0.05)。结论与显微镜下鼓室成形术相比,内镜下传音机构重建术治疗慢性中耳炎疗效更好,可有效改善听力学指标,促进听力恢复,提高生活质量,且安全性较好。Objective To compare the efficacy and safety of endoscopic reconstruction of sound transmission mechanism and microscopic tympanoplasty in the treatment of chronic otitis media.Methods A total of 62 patients with chronic otitis media admitted to Xinyang Central Hospital from September 2020 to September 2023 were prospectively selected as research objects and divided into study group and control group according to random number table method,with 30 cases in each group.The control group was treated with microscopic tympanoplasty,while the study group was treated with endoscopic reconstruction of sound transmission mechanism.The differences of efficacy related indexes,audiological indexes[bone conduction(BC),air conduction(AC),air-bone gap(ABG)],complications and quality of life[Zurich chronic middle ear inventory(ZCMEI)]between the two groups were compared.Results The results of rank sum test showed that there was statistical significance between the two groups(P<0.05).The total effective rate and hearing improvement rate of the study group were higher than those of the control group,and the perforation rate of eardrum and dry ear rate were lower than those of the control group(P<0.05).ABG and AC after treatment were lower than those before treatment(P<0.05).ABG and AC of the study group were lower than those of the control group after treatment(P<0.05),but there was no significant difference in BC between the two groups after treatment(P>0.05).There was no significant difference in the incidence of infection,eardrum invagination,vertigo and tinnitus between the two groups(P>0.05),but the total complication rate of the study group was lower than that of the control group(10.00%vs 33.33%)(P<0.05).After treatment,the score of medical data use,the score of otitis media symptoms,the score of subjective hearing level,the score of social psychological impact and the total score of ZCMEI were all lower than before treatment(P<0.05).The scores and total scores of ZCMEI in the study group were lower than those in the contro

关 键 词：慢性中耳炎 内镜下传音机构重建术 显微镜下鼓室成形术 疗效 安全性 

分 类 号：R764.1[医药卫生—耳鼻咽喉科]