药物支架辅助的内镜下鼓室成形术Ⅰ型治疗慢性化脓性中耳炎的疗效分析-现代医学

药物支架辅助的内镜下鼓室成形术Ⅰ型治疗慢性化脓性中耳炎的疗效分析

单位：1. 徐州医科大学第一临床医学院, 江苏徐州 221004;
2. 徐州医科大学附属医院耳鼻咽喉头颈外科, 江苏徐州 221004

分类号：R762

出版年·卷·期（页码）：2024·52·第九期（1391-1398）

摘要：

目的： 探讨药物支架辅助的内镜下鼓室成形术Ⅰ型治疗慢性化脓性中耳炎的疗效。方法： 选择2022年10月至2024年1月于我院治疗的124例单纯性慢性化脓性中耳炎患者为研究对象，随机分为实验组[64例(64耳)]和对照组[60例(60耳)]。实验组给予药物支架辅助的内镜下鼓室成形术Ⅰ型，对照组给予传统内镜下鼓室成形术Ⅰ型。记录两组患者的出血量、手术时间、住院时间、干耳时间、疗效、术后不良反应，术前术后的听力、疼痛视觉模拟评分(VAS)、患耳外耳道横截面积、生活质量综合评定问卷-74(GQOL-74)。结果： 与对照组比较，实验组的手术时间显著延长(P＜0.05)，两组的出血量和住院时间差异无统计学意义(P＞0.05)。术前，两组的气道听阈、气骨导差、骨导听阈、VAS、患耳外耳道横截面积、生活质量评分差异无统计学意义(P＞0.05)。术后2周、4周，两组的气道听阈、气骨导差、骨导听阈、VAS均有不同程度地降低(P＜0.05)，与对照组比较，实验组的气道听阈、气骨导差、骨导听阈、VAS均显著降低(P＜0.05)；与对照组比较，实验组术后3个月的患耳外耳道横截面积和生活质量均显著增高，干耳时间显著减少(P＜0.05)。与对照组比较，实验组的总有效率显著增高(P＜0.05)。两组各1例术后出现轻度感染，其余患者均未出现显著的不良反应。结论： 药物支架辅助的内镜下鼓室成形术Ⅰ型可用于治疗慢性化脓性中耳炎，可显著缩短干耳时间、改善听力、缓解疼痛、扩大患耳外耳道横截面积和改善生活质量。

Objective: To explore the therapeutic effect of drug stent-assisted endoscopic tympanoplasty type I in the treatment of chronic suppurative otitis media. Methods: From October 2022 to January 2024, 124 patients with simple chronic suppurative otitis media admitted to our hospital were collected and randomly divided into experimental group [64 cases(64 ears)]and control group [60 cases(60 ears)]. The experimental group received drug stent-assisted endoscopic tympanoplasty type I, while the control group received traditional endoscopic tympanoplasty type I. The bleeding volume, surgical time, hospital stay, dry ear time, therapeutic effect, postoperative adverse reactions, preoperative and postoperative hearing, pain visual analog scale(VAS), cross-sectional area of the affected ear canal, generic quality of life inventory-74(GQOL-74) of the 2 groups were documented. Results: Compared with the control group, the surgical time of the experimental group was significantly increased(P＜0.05). There was no statistically significant difference in bleeding volume and hospital stay between the 2 groups(P＞0.05). Before surgery, the airway hearing threshold, air bone conduction difference, bone conduction hearing threshold, VAS, cross-sectional area of the affected ear canal and quality of life score had no differences between the 2 groups(P＞0.05). At 2 and 4 weeks after surgery, the airway hearing threshold, air bone conduction difference, bone conduction hearing threshold, and VAS of the 2 groups were all reduced(P＜0.05). Compared with the control group, bone conduction hearing threshold, the airway hearing threshold, air bone conduction difference, and VAS of the experimental group were significantly reduced(P＜0.05). Compared with the control group, the cross-sectional area of the affected ear canal and quality of life score of the experimental group was significantly increased at 3 months after surgery, and the dry ear time was significantly reduced(P＜0.05). Compared with the control group, the total effective rate of the experimenal group was significantly increased(P＜0.05). 1 patient in each group had mild infection after surgery, and the rest of the patients had mild infection. Conclusion: Drug stent-assisted endoscopic tympanoplasty type I can be used to treat chronic suppurative otitis media, which can significantly shorten ear drying time, alleviate pain, improve hearing, increase cross-sectional area of the affected ear canal and improve quality of life.

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