学龄儿童鼓膜创伤原因及干预效果评价

Cause for Tympanic Membrane and Evaluation of Intervention Effect in Different Ages of Students

目的分析不同年龄段学生鼓膜创伤原因,为开展相关健康教育工作提供参考。方法回顾性分析2007年1月-2009年6月71例学生鼓膜创伤原因、损伤方式及穿孔愈合情况。结果 17例学龄前及小学生中,铅笔等直接损伤11例(64.7%),掌拳击伤4例(23.5%);54例中学生中掌拳击伤42例(77.8%),篮球击伤11例(20.4%)。71例儿童就诊原因分别为耳道出血19例(26.8%)、耳痛22例(31.0%)、有被打史35例(49.30%)。71例中,除2例感染外,69例穿孔愈合,其中33例(47.8%)自然愈合,愈合时间9～47 d;36例(52.2%)明胶海绵贴片修复愈合,愈合时间6～38 d。结论不同年龄段学生鼓膜创伤原因存在差异,学生鼓膜创伤后是否主动就医与其主诉能力及家长的重视程度有关,应针对不同学龄儿童采取相应干预措施。

Objective To analyze the cause for tympanic membrane in different ages of students and intervention effect, and to provide reference for the related health education. Methods A retrospective analysis of the injury causes, treatment measures and healing condition was made in 71students with traumatic perforation of tympanic membrane from January of 2007 to June of 2009. Results The direct injury （ 64.7%） by pencil and branch were the most frequent causes of tympanic membrane in 17 cases of preschool children and pupils, followed by boxing （23.5% ） The boxing （77.8%） were the most frequent causes of tympanic membrane in 54 cases of middle school students, followed hitting by basketball （20.4%）. The leading causes of students visiting were external bleeding（ 26.8% ）, earache （31.00%） and trauma history （49.30% ）. Except 2 infection, the healing rates of tympanic membrane perforation were 97.18% （ 69/71 ）, among them there were 33 cases （ 47.8% ） natural healing and 36 cases （52.2% ）by gelatin sponge respectively. The healing time were 9 to 47days and 6 to 38 days. Conclusion There are differences among the cause of tympanic membrane in different ages of students. The education department should take corresponding measures according to different students.