耳内镜下鼓膜修补术与耳科显微镜下鼓膜修补术的治疗效果比较
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摘要
目的比较耳内镜下鼓膜修补术与耳科显微镜下鼓膜修补术的治疗效果。方法根据治疗方法不同将医院收治的鼓膜修复术(穿孔直径<5 mm)患者82例分为观察组42例和对照组40例。观察组给予耳内镜下鼓膜修补术治疗;对照组给予耳科显微镜下鼓膜修补术治疗。比较2组临床疗效、术中出血量、术后疼痛情况及术前后听力情况。结果手术后1个月,2组总有效率比较差异无统计学意义(P>0.05)。2组术中出血量及术前纯音听阈比较差异均无统计学意义(P>0.05);术后2个月2组纯音听阈均低于术前,且观察组纯音听阈低于对照组,差异均有统计学意义(P<0.05)。观察组术后中重度疼痛发生率低于对照组,差异有统计学意义(P<0.05)。结论与显微镜下鼓膜修补术相比,对于穿孔直径<5 mm患者行耳内镜下鼓膜修补术的治疗效果更优。
Objective To compare the therapeutic effects of tympanic membrane repair under ear endoscope and tympanic membrane repair under otology microscope.Methods 82 patients with tympanic membrane repair(perforation diameter<5 mm) were divided into observation group(42 cases) and control group(40 cases) according to different treatment methods.The observation group was treated with tympanic membrane repair under ear endoscope,the control group was treated with tympanic membrane repair under otology microscope.The clinical efficacy,intraoperative blood loss,postoperative pain and hearing before and after surgery were compared between the two groups.Results One month after the operation,there was no significant difference in the total effective rate between the two groups(P>0.05).There was no significant difference in the mean bleeding volume between the two groups and the preoperative pure tone hearing threshold(P>0.05).At 2 months postoperatively,the pure tone threshold of the two groups was lower than that before the operation,and the pure tone hearing threshold of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).The incidence of moderate to severe pain in the observation group was lower than that in the control group(P<0.05).Conclusion Compare with tympanic repair under the microscope,the treatment of endoscopic tympanic membrane repair is better for patients with a perforation diameter of less than 5 mm.
Objective To compare the therapeutic effects of tympanic membrane repair under ear endoscope and tympanic membrane repair under otology microscope.Methods 82 patients with tympanic membrane repair(perforation diameter<5 mm) were divided into observation group(42 cases) and control group(40 cases) according to different treatment methods.The observation group was treated with tympanic membrane repair under ear endoscope,the control group was treated with tympanic membrane repair under otology microscope.The clinical efficacy,intraoperative blood loss,postoperative pain and hearing before and after surgery were compared between the two groups.Results One month after the operation,there was no significant difference in the total effective rate between the two groups(P>0.05).There was no significant difference in the mean bleeding volume between the two groups and the preoperative pure tone hearing threshold(P>0.05).At 2 months postoperatively,the pure tone threshold of the two groups was lower than that before the operation,and the pure tone hearing threshold of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).The incidence of moderate to severe pain in the observation group was lower than that in the control group(P<0.05).Conclusion Compare with tympanic repair under the microscope,the treatment of endoscopic tympanic membrane repair is better for patients with a perforation diameter of less than 5 mm.
引文
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[10] 周庆,刘雄光,吴昌林,等.耳内镜下耳屏软骨环-软骨膜修补术治疗鼓膜穿孔40例[J].山东大学耳鼻喉眼学报,2018,32(6):69-72.DOI:10.6040/j.issn.1673-3770.0.2018.203.
[2] 冯勇,卢雅艳,张艳萍,等.外伤性鼓膜穿孔早期贴膜修补术125例疗效观察[J].中国眼耳鼻喉科杂志,2013,13(5):315,317.DOI:10.3969/j.issn.1671-2420.2013.05.013.
[3] 丁建辉.探讨耳内镜在经耳道鼓膜修补术中的应用效果[J].中外医疗,2017,36(25):86-87,90.DOI:10.16662/j.cnki.1674-0742.2017.25.086.
[4] 周丰,张盛金,张耀明,等.耳内镜下双人操作外耳道皮瓣法治疗鼓膜大穿孔[J].实用医学杂志,2014,30(1):108-110.DOI:10.3969/j.issn.1006-5725.2014.01.037.
[5] 刘霞,马和平,钟凤如,等.鼓膜修补术经耳内镜下选择耳垂脂肪压片治疗的临床分析[J].中国医药科学,2014,4(15):195-197.DOI:10.3969/j.issn.2095-0616.2014.15.068.
[6] 南进军.耳内镜下鼓膜修补与显微镜下鼓膜修补效果比较[J].当代医学,2013,19(35):54-55.
[7] 刘秀姣,米晶晶,许雨洲.耳内镜辅助显微镜下鼓膜修补术60例临床分析[J].中国实用医药,2015,10(32):62-63.DOI:10.14163/j.cnki.11-5547/r.2015.32.040.
[8] 吴照红.耳内窥镜与耳科显微镜下耳屏软骨-软骨膜鼓膜修补术治疗鼓膜穿孔[J].中国现代手术学杂志,2018,22(3):217-221.DOI:10.16260/j.cnki.1009-2188.2018.03.014.
[9] 陶平,李新初,冯军.自体脂肪及耳屏软骨-软骨膜修补鼓膜穿孔临床疗效研究[J].中国社区医师,2018,34(10):82-83.
[10] 周庆,刘雄光,吴昌林,等.耳内镜下耳屏软骨环-软骨膜修补术治疗鼓膜穿孔40例[J].山东大学耳鼻喉眼学报,2018,32(6):69-72.DOI:10.6040/j.issn.1673-3770.0.2018.203.