摘要
目的探讨持续灌流模式耳内镜下鼓室成形术结合人工听骨链重建术治疗慢性化脓性中耳炎(CSOM)的效果。方法选取2021年7月至2024年7月苏州眼耳鼻喉科医院耳鼻喉科收治的CSOM患者64例,根据治疗方法不同分为对照组(n=31)和观察组(n=33),对照组采用持续灌流模式耳内镜下鼓室成形术治疗,观察组在此基础上结合人工听骨链重建术治疗。比较两组临床疗效、手术相关指标(术中出血量、住院时间)、听力恢复情况[气导听阈、骨导听阈、气骨导差(ABG)]、生活质量[采用慢性化脓性中耳炎患者生活质量量表(CSOM-QOL)评估]、术后并发症发生情况及复发情况。结果术后6个月,观察组临床有效率高于对照组(P<0.05)。与对照组比较,观察组出血量更少,住院时间更短(P<0.05)。观察组术后6个月气导听阈、骨导听阈、ABG均低于对照组,CSOM-QOL各维度评分均高于对照组(P<0.05)。两组术后并发症总发生率及复发率比较,差异无统计学意义(P>0.05)。结论持续灌流模式耳内镜下鼓室成形术结合人工听骨链重建术治疗CSOM的临床疗效显著,可有效改善CSOM患者的听力水平,降低ABG,缩短住院时间,提高生活质量,且不增加术后并发症及复发风险。
Objective To examine the effect of endoscopic tympanoplasty combined with artificial ossicular chain reconstruction under continuous perfusion mode in the treatment of chronic suppurative otitis media(CSOM).Methods A total of 64 patients with CSOM admitted to the Department of Otorhinolaryngology,Suzhou EENT Hospital from July 2021 to July 2024 were selected and divided into two groups:control(n=31)and observation(n=33)based on treatment techniques.The control group was treated with endoscopic tympanoplasty under continuous perfusion mode,and the observation group was treated with artificial ossicular chain reconstruction on this basis.The clinical efficacy,operation-related indicators(intraoperative blood loss,hospital stay),hearing recovery[air conduction hearing threshold,bone conduction hearing threshold,air-bone gap(ABG)],quality of life[assessed by quality of life related scales for chronic otitis media(CSOM-QOL)],postoperative complications and recurrence were compared between the two groups.Results At 6 months after operation,the observation group had a greater clinical rate compared to the control group(P<0.05).Compared with the control group,the observation group had less bleeding and shorter hospitalization time(P<0.05).At 6 months after operation,the air conduction hearing threshold,bone conduction hearing threshold and ABG in the observation group were lower than those in the control group,and the scores of each dimension of CSOM-QOL in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the total incidence of postoperative complications and recurrence rate between the two groups(P>0.05).Conclusion The clinical efficacy of continuous perfusion mode endoscopic tympanoplasty combined with artificial ossicular chain reconstruction in the treatment of CSOM is significant.It can effectively improve the hearing level of CSOM patients,reduce ABG,shorten hospitalization time,improve quality of life,and does not increase the risk of postoperative complications and recurrence.
作者
潘辰飞
丁群辉
陆春龄
PAN Chenfei;DING Qunhui;LU Chunling(Department of Otorhinolaryngology,Suzhou EENT Hospital,Suzhou,Jiangsu 215007,China)
出处
《医师在线》
2026年第1期63-67,共5页
Journal of Doctors Online
关键词
慢性化脓性中耳炎
鼓室成形术
耳内镜
人工听骨链重建术
持续灌流模式
气骨导差
Chronic suppurative otitis media
Tympanoplasty
Otoendoscope
Artificial ossicular chain reconstruction
Continuous perfusion mode
Air-bone gap
