乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎效果观察

The Clinical Observation on Radical Mastoidectomy and Myringoplasty in the Treatment of Chronic Suppurative Otitis Media and Cholesteatoma Otitis Media

目的:研究慢性化脓性及胆脂瘤中耳炎患者采用乳突根治联合鼓室成形术治疗的临床效果。方法:临床纳入102例笔者所在医院2014年1月-2016年8月收治的慢性化脓性及胆脂瘤中耳炎患者作为研究对象。按随机数字表法将患儿分为两组,各51例。对照组采用乳突根治术治疗,观察组在上述基础上联合鼓室成形术治疗。观察两组患者治疗效果、听力水平及并发症情况。结果:观察组治疗总有效率为94.12%,明显高于对照组的78.43%,差异有统计学意义(P<0.05)。术前两组患者气骨导差、气导听阈水平比较,差异无统计学意义(P>0.05);术后观察组上述指标均优于对照组,差异均有统计学意义(P<0.05)。两组患者术后并发症包括胆脂瘤复发、耳脓及神经损伤。观察组、对照组发生率分别为3.92%、13.73%,观察组明显较低,差异有统计学意义(P<0.05)。结论:乳突根治术联合鼓室成形术对慢性化脓性及胆脂瘤中耳炎患者治疗效果显著,术后听力明显改善,并发症发生率低,安全性较高,值得临床应用及推广。

Objective:To study the clinical effect of the adoption of combined radical mastoidectomy and myringoplasty on patients with chronicsuppurative otitis media and cholesteatoma otitis media.Method:102cases of patients with chronic suppurative otitis media and cholesteatoma otitis mediaadmitted to our hospital from January2014to August2016were served as research object and divided into two groups by random number table method,51cases ineach group.Among them,the control group were treated with radical mastoidectomy.On this basis,the observation group combined with myringoplasty to observethe therapeutic effects,hearing levels and complications of patients in two groups.Result:The total effective rate of observation group was94.12%,which wassignificantly higher than78.43%of control group(P<0.05).Before operation,there were no differences with regard to air bone gap and air conduction thresholdlevel for patients in two groups(P>0.05);after operation,the above mentioned indexes of the observation group were better than those of the control group,thedifferences were statistically significant(P<0.05).The postoperative complications of patients in two groups include recurrent cholesteatoma,ear pus and nerveinjury.The complication incidence of observation group and the control group were3.92%and13.73%respectively,it was significantly lower in observation groupthan that of the control group(P<0.05).Conclusion:Radical mastoidectomy combined with myringoplasty plays a significant effect on treatment of patients withchronic suppurative otitis media and cholesteatoma otitis media.After operation,the hearing is improved obviously with low complication rate and high safety so thatit is worthy of clinical application and promotion.