耳内镜与耳显微镜下鼓膜成形术的差异性比较

发布时间：2018-01-19 12:15

本文关键词： 中耳炎鼓膜成形术内镜术鼓膜穿孔听力　出处：《临床耳鼻咽喉头颈外科杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的:对耳内镜及耳显微镜下鼓膜成形术的术中、术后相关指标进行回顾性分析,比较2种不同手术方式的差异性。方法:回顾性分析喀什地区第二人民医院耳鼻咽喉头颈外科2014-06-2015-08期间70例(70耳)行鼓膜成形术的慢性化脓性中耳炎患者的临床资料,根据手术方式分为耳内镜下鼓膜成形术30例(A组),耳显微镜下鼓膜成形术40例(B组)。比较2组的手术时间、术中出血量及术后的干耳时间、切口愈合瘢痕增生情况、鼓膜穿孔率、听力改善率,利用SPSS 19.0统计软件分析2组之间的差异性。结果:手术时间:A组为(35.23±6.38)min,B组为(42.60±7.97)min,差异有统计学意义(P0.05)。术中出血量:A组为(7.33±2.11)ml,B组为(17.93±3.84)ml,差异有统计学意义(P0.05)。术后干耳时间超过1个月:A组为40%,B组为75%,差异有统计学意义(P0.05)。术后切口愈合瘢痕增生情况:A组为0%,B组为5%,差异无统计学意义(P0.05)。术后鼓膜穿孔率:A组为3.33%,B组为7.50%,差异无统计学意义(P0.05)。术后听力改善率:A组为76.67%,B组为80.00%,差异无统计学意义(P0.05)。结论:耳内镜下鼓膜成形术是一种微创外科技术,与传统耳显微镜下手术相比,术后可以获得相同的疗效,但具有手术时间短、术中出血量少、术后干耳时间短、恢复快、切口美观等优点,值得临床推广应用。
[Abstract]:Objective: to analyze retrospectively the operative and postoperative indexes of tympanoplasty under ear endoscope and otoscope. Methods: a retrospective analysis of 70 cases (70 ears) of otolaryngology and head and neck surgery in the second people's Hospital of Kashgar region from 2014-06-2015-08 was made. Clinical data of patients with chronic suppurative otitis media undergoing tympanoplasty. According to the operation mode, 30 cases were divided into two groups: group A (n = 30) and group B (n = 40). The operative time, blood loss during operation and dry ear time after operation were compared between the two groups. Wound healing scar proliferation, tympanic membrane perforation rate, hearing improvement rate. SPSS 19.0 software was used to analyze the difference between the two groups. Results: the operation time of group A was 35.23 卤6.38 minutes. Group B was 42.60 卤7.97 min, the difference was statistically significant (P 0.05), and the intraoperative bleeding volume of group A was 7.33 卤2.11 ml. Group B was 17.93 卤3.84 ml, the difference was statistically significant (P 0.05). The dry ear time was more than 1 month after operation in group B and group B was 75%. The difference was statistically significant (P 0.05). The rate of scar proliferation in group 0: a was 0 and B was 5%. The rate of perforation of tympanic membrane was 3.33% and 7.50% in group B after operation. There was no significant difference (P 0.05). The improvement rate of hearing in group A was 76.6767 and 80.00% in group B. Conclusion: endoscope tympanoplasty is a minimally invasive surgical technique, which can obtain the same curative effect compared with traditional ear microscope surgery. But it has the advantages of short operation time, less intraoperative bleeding, short dry ear time after operation, quick recovery, beautiful incision and so on.
【作者单位】：喀什地区第二人民医院耳鼻咽喉头颈外科;复旦大学附属眼耳鼻喉科医院耳鼻咽喉头颈外科;
【基金】：上海市科委2015年国内科技合作领域项目(No:15695841000)
【分类号】：R764.9
【正文快照】： 在耳显微镜下进行耳科手术是目前的主流手术方式,既往耳内镜作为显微手术的辅助工具,随着传统耳显微外科手术的进一步发展,目前耳内镜手术在耳外科领域也越来越受到重视[1]。随着内镜技术的不断发展,耳内镜技术逐渐开始在临床上普及应用,然而其应用还有一定的局限性[2],而且目

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