鼓膜微管置入术治疗中耳不张76例临床分析

Insertion of microtubules in tympanic membrane for the treatment of middle ear atelectasis

目的分析鼓膜微管置入术治疗中耳不张的临床疗效。方法选取76例中耳不张患者,根据Dornhffer的综合分析法分级分为两组各38例,A组为Ⅰ、Ⅱ级中耳不张患者,B组为Ⅲ、Ⅳ级中耳不张患者,对比两组术前、术后1周、1个月、6个月纯音听阈测听及声导抗结果,比较两组的治疗效果,观察并发症发生情况和复发情况。结果两组在术前和经过鼓膜微管置入术治疗后1周、1个月、6个月的纯音听阈测听结果变化趋势存在统计学差异(P均<0.05)。两组从治疗前到经手术治疗后1周、1个月、6个月的声导抗检查变化趋势均存在统计学差异(P均<0.05)。A组总有效36例(94.74%),B组总有效30例(78.95%),两组总有效率比较,差异有统计学意义(P<0.01)。A组并发症发生0例、复发0例,B组并发症发生2例(5.26%)、复发3例(7.89%),两组并发症发生率及复发率比较,差异有统计学意义(P均<0.05)。结论鼓膜微管置入术对Ⅰ、Ⅱ级中耳不张患者临床效果较好,能有效降低并发症发生率及复发率。

Objective To analyze the clinical efficacy of tympanic membrane microtubule placement in the treatment of middle ear edema. Methods Seventy-six patients with middle ear atelectasis were divided into two groups according to Dornhoffer＇s staging criteria. Group A was comprised of 38 patients with middle ear atelectasis classified as grade Ⅰ or Ⅱ,and group B was comprised of patients with grades Ⅲ or Ⅳ. The results of pure tone audiometry and acoustic impedance measurements were compared for the two groups before surgery and 1 week,1 month,and 6 months afterward,to assess the effects of treatment and observe the occurrence and recurrence of complications. Results There were statistically significant differences between the two groups in pure tone audiometry before tympanic microtubule implantation and at 1 week,1 month,and 6 months afterward（ P〈0.05）. There were also statistically significant differences in acoustic impedance before treatment and at 1 week,1 month and 6 months afterward（ P〈0.05）. In Group A,36 cases（ 94.74%） showed fully effectiveness,compared to 30 cases（ 78.95%） in group B. The difference in efficacy was significant（ P〈0.01）. In group A there were no cases of complications and no cases of recurrence,while in group B there were 2 cases（ 5.26%） with complications and 3 cases（ 7.89%） with recurrence. The incidence of complications and recurrence rate differed significantly in the two groups（ P〈0.05）. Conclusion Tympanic microtubule implantation has good clinical effects in patients with gradeⅠor Ⅱ middle ear atelectasis,and can effectively reduce the incidence of complications and recurrence rate.