周磊 曾京宇 李育广 罗立斌
[摘要] 目的 探讨慢性中耳炎患者采用乳突根治加鼓室成形术治疗的手术效果及对术后鼓膜穿孔感染、术后干耳情况的影响。 方法 选取2012年12月~2018年1月我院收治的200例慢性中耳炎患者为研究对象,根据手术方式不同分为对照组和综合组,每组100例。对照组采用乳突根治疗术,综合组采用乳突根治加鼓室成形术治疗。观察两组患者听力水平变化情况、临床疗效、术后鼓膜穿孔感染率、术后鼓膜成活情况及术后干耳情况。 结果 治疗后综合组气导听阀水平和气骨导差均低于对照组(P<0.05);综合组干耳率、总有效率和鼓膜成活率明显高于对照组(P<0.05)。 结论 给予慢性中耳炎患者采用乳突根治加鼓室成形术治疗,具有良好的治疗效果,能有效提高患者听力水平和术后干耳率。
[关键词] 慢性中耳炎;乳突根治疗术;鼓室成形术;术后鼓膜穿孔感染;术后干耳
[中图分类号] R764.21 [文献标识码] B [文章编号] 1673-9701(2020)04-0066-03
Treatment of chronic otitis media with radical mastoidectomy and tympanoplasty
ZHOU Lei ZENG Jingyu LI Yuguang LUO Libin
Department of Otorhinolaryngology Head and Neck Surgery, 908th Hospital of Joint Service Department, Yingtan 335000, China
[Abstract] Objective To investigate the treatment effect of radical mastoidectomy and tympanoplasty in patients with chronic otitis media as well as the influence on postoperative tympanic membrane perforation infection and postoperative dry ear condition. Methods A total of 200 patients with chronic otitis media admitted to our hospital from December 2012 to January 2018 were enrolled in the study. They were divided into control group and comprehensive group according to different surgical methods, with 100 cases in each group. The control group was treated with radical mastoidectomy, and the comprehensive group was treated with radical mastoidectomy combined with tympanoplasty. The changes of hearing level, clinical efficacy, postoperative tympanic membrane perforation rate, postoperative tympanic membrane survival and postoperative dry ear were observed. Results After treatment, the level of air-induced hearing valve and air-bone gap was lower in the comprehensive group than that in the control group(P<0.05). The dry ear rate, total effective rate and tympanic membrane survival rate of the comprehensive group were significantly higher than those of the control group(P<0.05). Conclusion The treatment of radical mastoidectomy and tympanoplasty in patients with chronic otitis media has good therapeutic effect and can effectively improve the hearing level and postoperative dry ear rate.
[Key words] Chronic otitis media; Radical mastoidectomy; Tympanoplasty; Postoperative tympanic membrane perforation infection; Postoperative dry ear
慢性中耳炎是一種较为常见的疾病,是由于中耳骨膜、黏膜或乳突骨质发生炎症,该病患者的主要临床症状为耳内反复流脓,伴随鼓膜穿孔及听力明显下降,常出现耳闷胀感和耳鸣。有研究表明,给予患者采用乳突根治加鼓室成形术治疗能够将病灶彻底清除,提高或保持患者的原有听力[1]。为了进一步探讨给予慢性中耳炎患者采用乳突根治加鼓室成形术治疗的手术效果以及对术后鼓膜穿孔感染、术后干耳情况的影响,本研究选取收治的200例慢性中耳炎患者开展研究,取得较为理想的临床效果,现报道如下。
综上所述,给予慢性中耳炎患者采用乳突根治加鼓室成形术治疗,具有良好的治疗效果,能够有效提高患者的听力水平和术后干耳率。
[参考文献]
[1] 蔡继红,尚规化,刘教练,等. 不同术式治疗慢性中耳炎的听力重建效果评价比较[J]. 解放军预防医学杂志,2018,36(12):1594-1596.
[2] 陈晓川. 乳突根治加鼓室成形术治疗慢性中耳炎的疗效分析[J]. 深圳中西医结合杂志,2018,28(14):169-170.
[3] 陈伟峰. 开放式鼓室成形术与乳突根治术联合治疗慢性化脓性中耳炎的临床效果[J]. 中国当代医药,2018, 25(26):115-117.
[4] 郑富春. 不同术式治疗慢性化脓性中耳炎的疗效及对患者生活质量的影响[J]. 医学临床研究,2018(2):327-330.
[5] 李雪华. 内镜下鼓室成形术治疗慢性中耳炎效果分析[J].河南外科学杂志,2018,24(1):157-159.
[6] 龙振华. 完壁式乳突根治联合开放式鼓室成型手术对胆脂瘤型中耳炎患者听力学的影响[J]. 河北医药,2017, 39(1):34-36.
[7] 张帅刚. 鼓室成型术治疗慢性化脓性中耳炎病的疗效及对患者预后的影响分析[J]. 现代诊断与治疗,2017, 28(22):4119-4121.
[8] 李力,谢静,刘韵,等. 乳突再根治术25例治疗体会[J]. 中华耳鼻咽喉头颈外科杂志,2017,52(10):766-770.
[9] 刘汉勇. 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[J]. 中外医学研究,2017,15(28):7-9.
[10] 龔树生,熊伟. 慢性中耳炎的规范化诊治[J]. 临床耳鼻咽喉头颈外科杂志,2017,31(16):1221-1224.
[11] 李湘宇,童钊君,胡中南. 乳突根治术联合鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎的临床疗效[J]. 临床合理用药杂志,2017,10(21):119-120.
[12] 赵发杰. 手术治疗慢性化脓性中耳炎50例总结[J]. 深圳中西医结合杂志,2017,27(13):97-99.
[13] 方敏,杨贵军,李朝军,等. 乳突病变切除加鼓室成形术与单纯鼓室成形术治疗中耳炎疗效的Meta分析[J]. 听力学及言语疾病杂志,2016,24(1):75-80.
[14] 李慧林,张志飞,谢马先,等. 单纯鼓室成形术与伴乳突切除的鼓室成形术治疗慢性化脓性中耳炎的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志,2017,(14):68-71.
[15] 王珏. 乳突根治加鼓室成形术治疗慢性化脓性及胆脂瘤中耳炎的临床疗效观察[J]. 中国卫生标准管理,2016,7(15):67-68.
(收稿日期:2019-10-21)