耳内镜下与显微镜下鼓膜修补术的临床应用对比

Comparison of Clinical Application of Tympanic Membrane Repair under Otoendoscope and under Microscope

目的:对比耳内镜下与显微镜下鼓膜修补术的临床应用效果。方法:选取2016年1月-2019年8月本院收治的70例慢性化脓性中耳炎鼓膜穿孔患者进行研究,按随机数字表法将其分为对照组和观察组,各35例。观察组采用耳内镜下鼓膜修补术,对照组采用显微镜下鼓膜修补术。比较两组的手术时间、术中出血量、住院时间、疼痛程度、切口美观满意度、纯音听阈和鼓膜愈合率、再穿孔率。结果:观察组手术时间和住院时间均短于对照组,出血量少于对照组,差异均有统计学意义(P<0.05)。观察组疼痛程度优于对照组,差异有统计学意义(P<0.05)。观察组对切口美观满意度高于对照组,差异有统计学意义(P<0.05)。术前,两组纯音听阈比较,差异无统计学意义(P>0.05);术后1、3个月,两组气导听阈、气骨导差均下降,且观察组均低于对照组,差异均有统计学意义(P<0.05)。两组术后1个月、6个月、1年鼓膜愈合率和再穿孔率比较,差异均无统计学意义(P>0.05)。结论:耳内镜下鼓膜修补术和显微镜下鼓膜修补术效果相当,与显微镜下鼓膜修补术相比,耳内镜下鼓膜修补术的优点在于手术时间和住院时间短、出血量少、疼痛程度轻、更加美观,可明显地提高纯音听阈,值得临床上广泛使用。

Objective:To compare the clinical application effect of tympanic membrane repair under otoendoscope and microscope.Method:A total of 70 patients with chronic suppurative otitis media with perforated tympanum admitted to our hospital from January 2016 to August 2019 were selected for study.They were divided into control group and observation group by random number table method,35 cases in each group.The observation group was treated with tympanic membrane repair under otoendoscope,while the control group was treated with tympanic membrane repair under microscope.The operation time,intraoperative blood loss,length of hospital stay,degree of pain,satisfaction degree of incision beauty,pure tone hearing threshold,tympanic membrane healing rate and re perforation rate were compared between the two groups.Result:The operative time and hospital stay of the observation group were shorter than those of the control group,and the blood loss was less than that of the control group,with statistically significant differences(P<0.05).The pain degree of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).The observation group was more satisfied with the incision aesthetics than that of the control group,the difference was statistically significant(P<0.05).Before the operation,there was no significant difference in pure tone hearing threshold between the two groups(P>0.05),at 1 and 3 months after the operation,the air conductance threshold and the air bone conductance difference of both groups were decreased,and the observation group were lower than those of the control group,with statistically significant differences(P<0.05).There were no significant differences between the two groups in the rate of eardrum healing and perforation rate at 1,6 months and 1 year after surgery(P>0.05).Conclusion:The results of otoendoscopy tympanic membrane repair and microscopic tympanic membrane repair are similar,compared with the repair of tympanic membrane under microscope,the advantages of otoendoscopy tympanic membrane repair are shorter operation time and hospitalization time,less blood loss,less pain,more beautiful,and significantly improve pure tone hearing threshold,it is worthy of clinical application.