乳突根治加鼓室成形術治療慢性化膿性及膽脂瘤中耳炎效果觀察

劉漢勇

【摘要】 目的：研究慢性化膿性及膽脂瘤中耳炎患者采用乳突根治聯合鼓室成形術治療的臨床效果。方法：臨床納入102例筆者所在醫院2014年1月-2016年8月收治的慢性化膿性及膽脂瘤中耳炎患者作為研究對象。按隨機數字表法將患兒分為兩組，各51例。對照組采用乳突根治術治療，觀察組在上述基礎上聯合鼓室成形術治療。觀察兩組患者治療效果、聽力水平及并發癥情況。結果：觀察組治療總有效率為94.12%，明顯高于對照組的78.43%，差異有統計學意義（P<0.05）。術前兩組患者氣骨導差、氣導聽閾水平比較，差異無統計學意義（P>0.05）；術后觀察組上述指標均優于對照組，差異均有統計學意義（P<0.05）。兩組患者術后并發癥包括膽脂瘤復發、耳膿及神經損傷。觀察組、對照組發生率分別為3.92%、13.73%，觀察組明顯較低，差異有統計學意義（P<0.05）。結論：乳突根治術聯合鼓室成形術對慢性化膿性及膽脂瘤中耳炎患者治療效果顯著，術后聽力明顯改善，并發癥發生率低，安全性較高，值得臨床應用及推廣。

【關鍵詞】 乳突根治術； 鼓室成形術； 慢性化膿性中耳炎； 膽脂瘤中耳炎； 療效

doi：10.14033/j.cnki.cfmr.2017.28.004 文獻標識碼 A 文章編號 1674-6805（2017）28-0007-03

【Abstract】 Objective：To study the clinical effect of the adoption of combined radical mastoidectomy and myringoplasty on patients with chronic suppurative otitis media and cholesteatoma otitis media.Method：102 cases of patients with chronic suppurative otitis media and cholesteatoma otitis media admitted to our hospital from January 2014 to August 2016 were served as research object and divided into two groups by random number table method，51 cases in each group.Among them，the control group were treated with radical mastoidectomy.On this basis，the observation group combined with myringoplasty to observe the therapeutic effects，hearing levels and complications of patients in two groups.Result：The total effective rate of observation group was 94.12%，which was significantly higher than 78.43% of control group（P<0.05）.Before operation，there were no differences with regard to air bone gap and air conduction threshold level for patients in two groups（P>0.05）；after operation，the above mentioned indexes of the observation group were better than those of the control group，the differences were statistically significant（P<0.05）.The postoperative complications of patients in two groups include recurrent cholesteatoma，ear pus and nerve injury.The complication incidence of observation group and the control group were 3.92% and 13.73% respectively，it was significantly lower in observation group than that of the control group（P<0.05）.Conclusion：Radical mastoidectomy combined with myringoplasty plays a significant effect on treatment of patients with chronic suppurative otitis media and cholesteatoma otitis media.After operation，the hearing is improved obviously with low complication rate and high safety so that it is worthy of clinical application and promotion.

【Key words】 Radical Mastoidectomy； Myringoplasty； Chronic suppurative otitis media； Cholesteatoma qtitis media； Curative effectendprint

First-authors address：The Peoples Hospital of Anyue，Anyue 642350，China

慢性化膿性中耳炎是臨床五官科常見的疾病之一，主要是由于中耳黏膜、骨膜發生慢性化膿性炎癥，且炎癥深達骨質[1]。其中膽脂瘤中耳炎也屬于慢性化膿性中耳炎中的一種，臨床常表現為持續性耳流膿，伴或不伴聽力下降。由于慢性化膿性中耳炎對中耳解剖結構和生理功能具有很強的破壞性，導致中耳結構和周圍軟骨受到損害，聽力功能下降，嚴重患者甚至危及生命安全，因此早期診斷治療是關鍵[2-3]。目前隨著醫療技術的不斷發展，對慢性化膿性中耳炎的治療已經不僅局限于傳統乳突根治術，鼓室成形術，在慢性化膿性中耳炎的治療上也有巨大效果[4]。本文對筆者所在醫院慢性化膿性及膽脂瘤中耳炎患者進行研究，探討乳突根治術聯合鼓室成形術對患者的療效，現報道如下。……