爆震伤鼓膜穿孔和单纯型中耳炎鼓膜修补术后的疗效分析
|
摘要
目的探讨爆震伤鼓膜穿孔及单纯型中耳炎患者经鼓膜修补术治疗的临床效果。方法从我院自2016年3月至2018年6月接受鼓膜修补患者62例,随机抽取单纯型中耳炎患者16例和2017年6月15日TNT爆炸致爆震伤鼓膜穿孔患者保守治疗观察4月后未愈者46例,观察所有患者的临床治疗效果,并探究其与患者年龄、穿孔大小之间的相关性。结果 62例患者综合愈合率为87.5%;其中爆震伤鼓膜穿孔愈合率显著低于单纯型中耳炎患者愈合率,二者愈合率与患者手术穿孔大小与手术类型无明显影响,且术后ABR水平显著优于术前(P <0.05),有统计学意义。结论移植床血供效果较差是导致爆震伤鼓膜穿孔经鼓膜修补术后的综合愈合率低于单纯型中耳炎患者的主要因素,手术过程中控制手术风险,提升移植床血供效果,是提升修补成功率的有效途径,值得推广。
Objective To explore the clinical effect of tympanic membrane repair for blast injury and simple otitis media. Methods From March 2016 to June 2018, 62 patients with tympanic membrane repair were randomly selected from our hospital. 16 patients with simple otitis media and 46 patients with blast-induced tympanic membrane perforation in 2017.06.15 TNT explosion were treated conservatively. The clinical effects of all patients were observed,and the correlation between them and age and size of perforation was explored. Results The overall healing rate of 62 patients was 87.5%. The healing rate of blast wound tympanic membrane perforation was significantly lower than that of simple otitis media patients. The healing rate of blast wound tympanic membrane perforation had no significant influence on the size and type of perforation, and the level of ABR after operation was significantly better than that before operation, P <0.05, with statistical significance. Conclusion The poor effect of blood supply in the transplantation bed is the main reason that the comprehensive healing rate of tympanic membrane perforation after tympanic membrane repair is lower than that of patients with simple otitis media.Controlling the risk of operation and improving the effect of blood supply in the transplantation bed are the effective ways to improve the success rate of tympanic membrane repair and are worth popularizing.
Objective To explore the clinical effect of tympanic membrane repair for blast injury and simple otitis media. Methods From March 2016 to June 2018, 62 patients with tympanic membrane repair were randomly selected from our hospital. 16 patients with simple otitis media and 46 patients with blast-induced tympanic membrane perforation in 2017.06.15 TNT explosion were treated conservatively. The clinical effects of all patients were observed,and the correlation between them and age and size of perforation was explored. Results The overall healing rate of 62 patients was 87.5%. The healing rate of blast wound tympanic membrane perforation was significantly lower than that of simple otitis media patients. The healing rate of blast wound tympanic membrane perforation had no significant influence on the size and type of perforation, and the level of ABR after operation was significantly better than that before operation, P <0.05, with statistical significance. Conclusion The poor effect of blood supply in the transplantation bed is the main reason that the comprehensive healing rate of tympanic membrane perforation after tympanic membrane repair is lower than that of patients with simple otitis media.Controlling the risk of operation and improving the effect of blood supply in the transplantation bed are the effective ways to improve the success rate of tympanic membrane repair and are worth popularizing.
引文
[1]许敏,高伟,李晓媛,等.外伤性鼓膜穿孔和单纯慢性化脓性中耳炎鼓膜成形术的疗效比较[J].中华耳科学杂志,2015,13(1):63-66.
[2]陈阳,许敏,邱建华.外伤性鼓膜穿孔和单纯型慢性化脓性中耳炎鼓膜成形术的疗效比较[C]//三次耳鼻咽喉学术会议.2016.
[3]刘利军,刘志锋,唐洪波.鼓膜成形术的临床应用效果观察[J].临床合理用药杂志,2016,9(31):34-35.
[4]李明全.药物治疗与鼓膜成形术对单纯慢性化脓性中耳炎患者听力的影响[J].河南外科学杂志,2017,23(2):52-58.
[5]柴向华,廖光美.三氯醋酸烧灼加祛腐生肌散外用治疗慢性中耳炎鼓膜穿孔的疗效观察[J].中国中西医结合耳鼻咽喉科杂志2016,24(3):6-8.
[7]何松跃.耳内窥镜手术治疗慢性化脓性中耳炎效果观察[J].河南医学研究,2017,27(17):118-120.
[8]梁波.耳内镜下单纯鼓膜修复术治疗慢性化脓性中耳炎的效果及安全性分析[J].当代医药论丛,2017,15(7):28-30.
[9]韩琳,王梦航,郑宏伟,等.慢性化脓性中耳炎鼓膜紧张部大穿孔手术方法的选择[J].中华耳科学杂志,2016,14(2):120.
[10]李元庆.耳内镜下鼓膜修补术与显微镜下鼓膜修补术的比较[J].世界最新医学信息文摘,2017,17(3):69-70.
[11]冯宁宇,张莹,申学良,等.活动期和静止期中耳炎鼓膜成形术疗效分析[J].宁夏医科大学学报,2018,40(1):85-87.
[12]曹凯峰.分泌性中耳炎采用鼓膜穿刺加地塞米松鼓室注射治疗的临床观察[J].医药前沿,2016,6(1):115-116.
[2]陈阳,许敏,邱建华.外伤性鼓膜穿孔和单纯型慢性化脓性中耳炎鼓膜成形术的疗效比较[C]//三次耳鼻咽喉学术会议.2016.
[3]刘利军,刘志锋,唐洪波.鼓膜成形术的临床应用效果观察[J].临床合理用药杂志,2016,9(31):34-35.
[4]李明全.药物治疗与鼓膜成形术对单纯慢性化脓性中耳炎患者听力的影响[J].河南外科学杂志,2017,23(2):52-58.
[5]柴向华,廖光美.三氯醋酸烧灼加祛腐生肌散外用治疗慢性中耳炎鼓膜穿孔的疗效观察[J].中国中西医结合耳鼻咽喉科杂志2016,24(3):6-8.
[7]何松跃.耳内窥镜手术治疗慢性化脓性中耳炎效果观察[J].河南医学研究,2017,27(17):118-120.
[8]梁波.耳内镜下单纯鼓膜修复术治疗慢性化脓性中耳炎的效果及安全性分析[J].当代医药论丛,2017,15(7):28-30.
[9]韩琳,王梦航,郑宏伟,等.慢性化脓性中耳炎鼓膜紧张部大穿孔手术方法的选择[J].中华耳科学杂志,2016,14(2):120.
[10]李元庆.耳内镜下鼓膜修补术与显微镜下鼓膜修补术的比较[J].世界最新医学信息文摘,2017,17(3):69-70.
[11]冯宁宇,张莹,申学良,等.活动期和静止期中耳炎鼓膜成形术疗效分析[J].宁夏医科大学学报,2018,40(1):85-87.
[12]曹凯峰.分泌性中耳炎采用鼓膜穿刺加地塞米松鼓室注射治疗的临床观察[J].医药前沿,2016,6(1):115-116.