慢性中耳炎患者進行耳內鏡下微創鼓室成形術治療的效果分析

陳楚亮 陳丙輝

[摘要] 目的 探討分析慢性中耳炎患者進行耳內鏡下微創鼓室成形術治療的效果。方法 方便選取2016年6月—2018年6月該院收治的80例慢性中耳炎患者，隨機分為觀察組與對照組各40例。對照組患者采用傳統顯微鏡下鼓室成形術進行治療，觀察組患者采用耳內鏡下鼓室成形術進行治療。比較兩組患者手術時間、術中出血量、術后24 h疼痛程度、臨床療效及術后并發癥發生情況之間的差異。 結果 觀察組患者的手術時間（70.1±6.8）min明顯低于對照組的（95.4±8.2）min（t=15.021，P=0.000），術中出血量（10.7±3.0）mL明顯低于對照組的（27.6±5.8）mL（t=16.368，P=0.000）、術后24 h疼痛程度VAS評分（2.4±0.4）分明顯低于對照組的（4.1±0.9）分（t=10.917，P=0.000），臨床療效明顯優于對照組（Z=2.332，P=0.020）。兩組患者術后皆未發生相關并發癥。 結論 耳內鏡下微創鼓室成形術治療慢性中耳炎患者，能夠有效的縮短手術時間，降低術中出血量與術后疼痛程度，提高臨床治療效果，安全性較高，值得推廣應用。

[關鍵詞] 慢性中耳炎;耳內鏡;微創;鼓室成形術

[中圖分類號] R764.21? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）06（b）-0110-03

[Abstract] Objective To analyze the effect of endoscopic minimally invasive tympanoplasty in patients with chronic otitis media. Methods Convenient select eighty patients with chronic otitis media admitted to the hospital from June 2016 to June 2018 were randomly divided into observation group and control group. The patients in the control group were treated with conventional tympanoplasty under the microscope， and the patients in the observation group were treated with endoscopic tympanoplasty. The differences between the operation time， the amount of intraoperative blood loss， the degree of pain at 24 h after surgery， clinical efficacy and postoperative complications were compared between the two groups. Results The operation time of the observation group （70.1±6.8） min was significantly lower than that of the control group （95.4±8.2） min （t=15.021， P=0.000）， and the intraoperative blood loss （10.7±3.0） mL was significantly lower than the control group （27.6±5.8） mL （t=16.368， P=0.000）， 24h postoperative pain VAS score （2.4±0.4）points was significantly lower than the control group （4.1±0.9） points （t=10.917， P= 0.000）， the clinical efficacy was significantly better than the control group （Z=2.332， P=0.020）. No complications occurred in either group after surgery. Conclusion Endoscopic minimally invasive tympanoplasty for patients with chronic otitis media can effectively shorten the operation time， reduce the amount of intraoperative blood loss and postoperative pain， improve the clinical treatment effect， and have high safety. It is worthy of popularization and application.

[Key words] Chronic otitis media; Endoscopic surgery; Minimally invasive; Tympanoplasty

慢性中耳炎是耳鼻咽喉科臨床上頗為常見的疾病，主要表現為鼓膜穿孔、患耳反復流膿、聽力下降等，嚴重者還可引起顱內外并發癥的發生，需要及時進行手術治療[1]。傳統術式常采用耳后切口下顯微鏡鼓室成形術，但該術式的創傷較大，手術視野差，預后較慢，難以滿足患者及家屬日益增長的臨床療效需求[2-3]。近年來，隨著精準醫療觀念的提出與微創技術的不斷發展，耳內鏡下微創鼓室成形術成為了一種新型術式，為慢性中耳炎治療提供了新的思路[4-5]。該研究中，方便選取2016年6月—2018年6月收治的80例慢性中耳炎患者，實施耳內鏡下微創鼓室成形術，取得了較好的臨床治療效果。現報道如下。