慢性中耳炎患者进行耳内镜下微创鼓室成形术治疗的效果分析

陈楚亮 陈丙辉

[摘要] 目的 探讨分析慢性中耳炎患者进行耳内镜下微创鼓室成形术治疗的效果。方法 方便选取2016年6月—2018年6月该院收治的80例慢性中耳炎患者，随机分为观察组与对照组各40例。对照组患者采用传统显微镜下鼓室成形术进行治疗，观察组患者采用耳内镜下鼓室成形术进行治疗。比较两组患者手术时间、术中出血量、术后24 h疼痛程度、临床疗效及术后并发症发生情况之间的差异。 结果 观察组患者的手术时间（70.1±6.8）min明显低于对照组的（95.4±8.2）min（t=15.021，P=0.000），术中出血量（10.7±3.0）mL明显低于对照组的（27.6±5.8）mL（t=16.368，P=0.000）、术后24 h疼痛程度VAS评分（2.4±0.4）分明显低于对照组的（4.1±0.9）分（t=10.917，P=0.000），临床疗效明显优于对照组（Z=2.332，P=0.020）。两组患者术后皆未发生相关并发症。 结论 耳内镜下微创鼓室成形术治疗慢性中耳炎患者，能够有效的缩短手术时间，降低术中出血量与术后疼痛程度，提高临床治疗效果，安全性较高，值得推广应用。

[关键词] 慢性中耳炎;耳内镜;微创;鼓室成形术

[中图分类号] R764.21          [文献标识码] A          [文章编号] 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颇为常见的疾病，主要表现为鼓膜穿孔、患耳反复流脓、听力下降等，严重者还可引起颅内外并发症的发生，需要及时进行手术治疗[1]。传统术式常采用耳后切口下显微镜鼓室成形术，但该术式的创伤较大，手术视野差，预后较慢，难以满足患者及家属日益增长的临床疗效需求[2-3]。近年来，随着精准医疗观念的提出与微创技术的不断发展，耳内镜下微创鼓室成形术成为了一种新型术式，为慢性中耳炎治疗提供了新的思路[4-5]。该研究中，方便选取2016年6月—2018年6月收治的80例慢性中耳炎患者，实施耳内镜下微创鼓室成形术，取得了较好的临床治疗效果。现报道如下。