耳内镜下鼓膜修补术对鼓膜穿孔患者围术期指标及听力恢复的影响

Effect of Tympanic Membrane Repair Surgery Under Otoendoscope on Perioperative Indexes and Hearing Recovery in Patients with Tympanic Membrane Perforation

目的探讨耳内镜下鼓膜修补术治疗鼓膜穿孔患者对其围术期指标及听力恢复的影响.方法选取我院2020年6月—2022年5月收治的88例鼓膜穿孔患者为研究对象,按随机数字表法分为两组,各44例.对照组采用显微镜下鼓膜修补术治疗,观察组采用耳内镜下鼓膜修补术治疗,均随访3个月.比较两组围术期指标、听力恢复情况、生活质量以及并发症.结果观察组手术时间、住院时间分别为(62.38±5.49)min、(3.52±0.41)d,均短于对照组的(78.45±6.38)min、(4.67±0.45)d,术中出血量为(6.89±1.12)mL,少于对照组的(13.54±1.58)mL,术后6 h疼痛视觉模拟评分为(2.75±0.32)分,低于对照组的(4.12±0.43)分,术后3个月气导听阈、气骨导差分别为(28.49±2.82)dB、(14.25±1.39)dB,均低于对照组的(32.12±3.14)dB、(16.36±1.44)dB,组间差异有统计学意义(P<0.05).观察组术后3个月世界卫生组织生活质量测定量表简表中生理、心理、环境及社会领域评分分别为(89.58±5.13)分、(87.41±5.82)分、(92.47±3.25)分、(90.75±4.13)分,均高于对照组的(82.34±5.08)分、(81.25±5.73)分、(86.54±5.45)分、(84.69±5.37)分,并发症发生率低于对照组,组间差异有统计学意义(P<0.05).结论耳内镜下鼓膜修补术治疗鼓膜穿孔的效果更佳,能缩短手术时间,减少术中出血量,促进听力恢复,降低疾病对患者生活的影响,且安全可靠.

Objective To investigate the effect of tympanic membrane repair surgery under otoendoscope on perioperative indexes and hearing recovery of patients with tympanic membrane perforation.Methods 88 patients with tympanic membrane perforation admitted to the hospital from June 2020 to May 2022 were selected as the research objects,and divided into two groups according to the random number table,44 patients in each group.The control group was treated with tympanic membrane repair surgery under microscope,and the observation group was treated with tympanic membrane repair surgery under otoendoscope,both groups were followed up for 3 months.Perioperative indexes,hearing recovery,quality of life and complications were compared between the two groups.Results The operation time and hospitalization time in the observation group were(62.38±5.49)min and(3.52±0.41)d,respectively,which were shorter than(78.45±6.38)min and(4.67±0.45)d in the control group,the intraoperative bleeding volume was(6.89±1.12)mL,which was less than(13.54±1.58)mL in the control group,the pain visual analogue scale score was(2.75±0.32)points at 6 h after operation,which was lower than(4.12±0.43)points in the control group,the air conduction hearing threshold and air bone conduction difference were(28.49±2.82)dB,(14.25±1.39)dB at 3 months after operation,respectively,which were lower than(32.12±3.14)dB and(16.36±1.44)dB in the control group,and the differences between the groups were statistically significant(P<0.05).The scores of physiological,psychological,environmental and social fields in the observation group were(89.58±5.13)points,(87.41±5.82)points,(92.47±3.25)points,and(90.75±4.13)points at 3 months after operation,respectively,which were higher than(82.34±5.08)points,(81.25±5.73)points,(86.54±5.45)points,and(84.69±5.37)points in the control group,the complication rate was lower than that of the control group.and the differences between the groups were statistically significant(P<0.05).Conclusion Tympanic membrane repair surgery under otoendoscope is more effective in the treatment of tympanic membrane perforation,which can shorten the operation time,reduce intraoperative bleeding volume,promote hearing recovery,reduce the impact of disease on patients'lives,and it is safe and reliable.