鼓膜修补术在慢性化脓性中耳炎伴耳鸣患者中的疗效研究

发布时间：2018-10-04 21:24

【摘要】：目的:分析慢性化脓性中耳炎患者鼓膜修补术后听力提高与耳鸣改善程度之间的关系。方法:收集2015-05-2016-12期间在西安交通大学第二附属医院行鼓膜修补术的慢性化脓性中耳炎(静止期)患者的临床资料,共35例伴有患侧或不明部位的耳鸣。所有患者术前及术后3个月分别使用电子耳镜检查鼓膜像,行耳鸣致残量表(THI)测试明确耳鸣情况,听力评估以500、1 000、2 000和4 000Hz的气导(AC)、骨导(BC)、骨气导差(ABG)表示。比较患者术前及术后AC、BC和ABG等听力学指标及THI得分的差异,并分析其相关性。结果:所有患者鼓膜修补术后一期愈合良好,自觉听力提高,无再穿孔。术后耳鸣均有不同程度缓解,无耳鸣加重。术后THI评分(15.0±5.6)较术前(21.2±7.4)显著降低(t=7.8,P0.01)。患者术后AC[(32.5±10.0)dBHL]和ABG[(18.3±7.7)dBHL]显著低于术前AC[(41.6±9.9)dBHL]和ABG[(27.0±7.4)dBHL],差异有统计学意义(均P0.01),但术后BC[(13.9±6.0)dBHL]与术前[(14.5±5.9)dBHL]比较差异无统计学意义(t=1.2,P0.05)。患者术后AC与ABG的降低与THI评分的降低均呈显著正相关(r=0.9,P0.01)。结论:鼓膜修补术在提高患者听力的同时可改善患者的耳鸣情况,是改善慢性化脓性中耳炎患者耳鸣症状的一种良好的外科手段。
[Abstract]:Objective: to analyze the relationship between hearing improvement and tinnitus improvement after tympanic membrane repair in patients with chronic suppurative otitis media. Methods: the clinical data of 35 patients with chronic suppurative otitis media (static stage) who underwent tympanic membrane repair in the second affiliated Hospital of Xi'an Jiaotong University from May to December 2015-2016-12 were collected. Tympanic membrane images were examined by electronic otoscope before operation and 3 months after operation. Tinnitus disability scale (THI) was used to determine tinnitus. The hearing was evaluated by air-guided (AC), (AC), bone conduction (BC), bone air conduction difference (ABG) of 500 ~ 1 000 and 4 000Hz respectively. To compare the difference of AC,BC and ABG and THI scores before and after operation, and to analyze their correlation. Results: all the patients healed well after tympanic membrane repair. The tinnitus was relieved to some extent after operation, and no increase of tinnitus was found. The postoperative THI score (15.0 卤5.6) was significantly lower than that before operation (21.2 卤7.4) (t = 7.8 卤P0.01). Postoperative AC [(32.5 卤10.0) dBHL] and ABG [(18.3 卤7.7) dBHL] were significantly lower than those of preoperative AC [(41.6 卤9.9) dBHL] and ABG [(27.0 卤7.4) dBHL] (all P 0.01), but there was no significant difference between postoperative BC [(13.9 卤6.0) dBHL] and preoperative [(14.5 卤5.9) dBHL] (P 0.05). There was a significant positive correlation between the decrease of AC and ABG and the decrease of THI score after operation (r = 0.9 P 0.01). Conclusion: tympanic membrane repair can improve hearing and tinnitus in patients with chronic suppurative otitis media. It is a good surgical method to improve the symptoms of tinnitus in patients with chronic suppurative otitis media.
【作者单位】：西安交通大学第二附属医院耳鼻咽喉头颈外科;
【分类号】：R764.9

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