鼓膜外伤性穿孔不同时间点治疗对闭合的影响

Effect of Treatment at Different Time Points for Traumatic Tympanic Membrane Perforation

目的回顾性分析鼓膜外伤性穿孔不同接诊时间点明胶海绵贴片及鼓膜瓣修复的疗效。方法不同时间点(第1天、第2天、第3天、第4天和第5～7天)接诊的鼓膜外伤性穿孔分别给予明胶海绵贴片及鼓膜瓣修复治疗,评估3个月时穿孔闭合率及平均闭合时间。结果明胶海绵组不同时间点治疗的穿孔闭合率分别为100%、100%、96%、94%和89%,差异无显著性(P>0.05);平均闭合时间分别为7.1±2.3天、8.2±1.6天、8.7±1.2天、9.2±3.1天和10.7±3.9天,差异无显著性(P>0.05);鼓膜瓣修复组不同时间点治疗的穿孔闭合率分别为100%、97%、96%、97%和94%,差异无显著性(P>0.05);平均闭合时间分别为7.6±1.9天、7.9±2.2天、9.2±2.8天、8.5±3.6天和11.2±4.1天,差异无显著性(P>0.05)。结论鼓膜外伤性穿孔缘外翻或内卷鼓膜瓣伤后1周内不同时间点处理对穿孔闭合率及平均闭合时间无明显影响。

Objective To retrospectively analyze the effect of treatment at different time points for traumatic tympanic membrane perforation with gelatin sponge patch and tympanic membrane flap （TMF） repair. Methods Patients with traumatic tyinpanic membrane perforation visited at different time points （1 st day, 2nd day, 3rd day, 4th day and 5th -7th clay） were given gelatin sponge patch treat- ment and TMF repair treatment, respectively. Perforation closure rate and mean closure time at 3 months. Results in gelatin sponge patch group treated at different time points, the perforation closure rates were 100% , 100% , 96% , 94% and 89% , respectively, and the differences were not significant （P 〉 0. 05） ; the mean closure times were 7. 1 ± 2.3,8.2 ± 1.6,8.7 ± 1.2,9.2 ± 3. 1 and 10.7 ± 3.9days,and the differences were not significant （P 〉 0.05 ）. In TMF repair group treated at different time points, the perforation closure rates were 100% , 97% , 96% , 97% and 94% , respectively, and the differences were not significant （P 〉 0.05 ） ; the mean closure times were 7.6 ± 1.9,7.9 ± 2.2,9.2 ± 2.8,8.5 ± 3.6 and 11.2 ± 4. ldays, respectively, and the differences were not significant （P 〉 0. 05）. Conclusion Treatment at different time points within 1 week after injury of everted or involute TMF of the traumatic tympanic membrane perforation edge has no effect on perforation closure rate and mean closure time.