双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响

Effect of Binocular Surgery Microscope and Otoendoscope on Perioperative indexes,Hearing recovery and Complications in the Patients with Artificial Stapes Surgery

目的观察双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响.方法选取遂宁市中心医院行人工镫骨手术患者160例,依据术中放大设备差异分为A组(n=80)与B组(n=80),A组采用双目手术显微镜,B组采用耳内镜,比较2组围术期指标(手术时间、术后苏醒时间、住院时间),并观察2组术前与术后3个月听力变化、并发症情况.结果 A组手术时间与术后苏醒时间均明显短于对照组(P<0.05),2组住院时间比较差异无统计学意义(P>0.05);术后3个月,2组气导听阈、气骨导间距均较术前明显降低(P<0.05),且组间比较差异无统计学意义(P>0.05);2组术后并发症总发生率比较差异无统计学意义(P>0.05),所有并发症经对症处理后完全消失.结论与耳内镜相比,双目手术显微镜下行人工镫骨手术,手术时间短,术后麻醉苏醒快,2种放大设备在恢复患者听力方面的疗效相当,且并发症均较少.

Objective To observe the effect of binocular surgery microscope and otoendoscope on perioperative indexes,hearing recovery and complications in the patients with artificial stapes surgery. Me thods A total of 160 patients undergoing artificial stapes surgery in the hospital were recruited and were divided into group A（n = 80） and group B（n = 80） according to different magnifying devices used during the surgery. The binocular surgery microscope was used in group A while the otoendoscope was used in group B. The perioperative indexes（surgical time, postoperative recovery time and hospital stay） were compared between the two groups. The changes of hearing and complications in the two groups before surgery and at 3 months after the surgery were observed.Re s ults The surgical time and postoperative recovery time of group A were significantly shorter than those of group B（P〈0.05）. There was no significant difference in hospital stay between the two groups（P〉0.05）. Three months after surgery,the air mediated hearing threshold and air bone gap in the two group significantly decreased（P〈0.05）, but there was no significant difference between the two groups（P〉0.05）. There was no significant difference in the total incidence of postoperative complications between the two groups（P〉0.05）, and all the complications completely disappeared after treatment. Conclus ion Compared with otoendoscope, the time of artificial stapes surgery under binocular surgery microscope is shorter and patients can recover quickly fromanesthesia after surgery. Effects of the two magnifying devices are similar in terms of hearing recovery and with few complications.