耳内镜应用于小儿鼓膜修补术中的临床效果

Clinical Effect of Otoendoscope in Tympanic Membrane Repair in Children

目的:探究与分析耳内镜应用于小儿鼓膜修补中的临床效果。方法:回顾性分析2018年4月-2021年2月北京市顺义区妇幼保健院收治的80例慢性化脓性中耳炎合并鼓膜穿孔患者的临床资料,按照不同的手术方式将其分为耳显微镜组(n=48),耳内镜组(n=32)。比较两组围手术期指标、气导听阈、骨导听阈、气骨导差、儿童少年生活质量量表(QLSCA)评分、视觉模拟评分法(VAS)评分,同时观察两组术后并发症发生率。结果:耳内镜组手术时间、住院时间短于耳显微镜组,出血量少于耳显微镜组,差异有统计学意义(P<0.05)。术后1个月,两组气导听阈、骨导听阈、气骨导差均低于术前,差异有统计学意义(P<0.05);而两组气导听阈、骨导听阈、气骨导差比较,差异无统计学意义(P>0.05)。术后1个月,两组QLSCA评分高于术前,VAS评分低于术前,且耳内镜组QLSCA评分高于耳显微镜组,VAS评分低于耳显微镜组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:相比于耳显微镜,耳内镜下实施小儿中耳检查及鼓膜修补术效果更好,围手术期指标表现更好,可提高患者术后生活质量,降低术后疼痛感,整体安全性较高。

Objective:To explore and analyze the clinical effect of otoendoscope in tympanic membrane repair in children.Method:The clinical data of 80 patients with chronic suppurative otitis media combined with tympanic membrane perforation admitted to Beijing Shunyi Maternal and Child Health Care Hospital from April 2018 to February 2021 were retrospectively analyzed.They were divided into otomicroscope group(n=48)and otoendoscope group(n=32)according to different surgical methods.The perioperative indicators,air conduction hearing threshold,bone conduction hearing threshold,air bone conduction difference,quality of life scale for children and adolescents(QLSCA)score,and visual analogue scale(VAS)score were compared between the two groups,and observed the incidence of postoperative complication in both groups.Result:The surgery time and hospitalization time of the otoendoscope group were shorter than those of the otomicroscope group,and the amount of bleeding was less than that of the otomicroscope group,the differences were statistically significant(P<0.05).One month after surgery,the air conduction hearing threshold,bone conduction hearing threshold,and air bone conduction difference in both groups were lower than those before surgery,the differences were statistically significant(P<0.05).However,there were no statistically significant differences in air conduction hearing threshold,bone conduction hearing threshold,and air bone conduction difference between the two groups(P>0.05).One month after surgery,the QLSCA scores in both groups were higher than those before surgery,while the VAS scores were lower than those before surgery,additionally,the QLSCA score of the otoendoscope group was higher than that of the otomicroscope group,and the VAS score was lower than those of the otomicroscope group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared to otomicroscope,performing pediatric tympanic membrane repair under otoendoscope has a better effect,better perioperative performance,and can improve patients'postoperative quality of life,reduce postoperative pain,and have higher overall safety.