| 张星宇,许为青,王胜军,刘晓薇,尹 飞.中耳炎一期鼓室成形术后听力重建效果及影响因素[J].,2020,(17):3380-3383 |
| 中耳炎一期鼓室成形术后听力重建效果及影响因素 |
| Hearing Reconstruction Effect and influencing Factors after Otitis Media Tympanoplasty |
| 投稿时间：2020-03-05 修订日期：2020-03-28 |
| DOI：10.13241/j.cnki.pmb.2020.17.041 |
| 中文关键词: 中耳炎 鼓膜穿孔 听力重建 听骨链 影响因素 |
| 英文关键词: Otitis media Tympanic membrane perforation Hearing reconstruction Ossicular chain Influencing factors |
| 基金项目:国家卫生计生委医药卫生科技发展研究项目（W2016CAE173） |
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| 中文摘要: |
| 摘要 目的：探讨中耳炎一期鼓室成形术后听力重建效果及影响因素。方法：2008年6月至2019年9月在本院耳鼻咽喉科进行手术治疗的中耳炎患者70例，所有患者都给予乳突切除和鼓室成形术，其中行上鼓室切开+鼓室成形术3例，行完桥式乳突切除+鼓室成形术2例，行完壁式乳突切除+鼓室成形术25例，行开放式乳突切除+鼓室成形术40例；行Ⅰ型鼓室成形术24例，行Ⅱ型鼓室成形术42例，行Ⅲ型鼓室成形术4例；用颞肌筋膜修补鼓膜的29例，用耳屏软骨-软骨膜复合体41例。计算术前和术后气骨导间距（air-bone gap），即500 Hz、1 KHz、2 KHz和4 KHz 4个频率气导均值与骨导均值的差，术后气骨导间距不大于20 dB为有效，归于有效组，大于20 dB为无效，归于无效组。结果：有效例数为42例，无效例数为28例，有效率为60 %。将术前和术后气骨导间距进行配对t检验和直线相关分析，两者有显著性差异（P<0.05）和显著性相关（P<0.05）。将术后听力效果（即有效和无效）作为因变量，以病人性别、病人年龄、病程、随访间隔、中耳炎种类、手术类型、鼓室成形类型和修补材料作为自变量，行Logisitic回归分析，未能发现对术后听力效果有影响的因素（P>0.05）。结论：大多数患者受益于一期听力重建，部分患者听力重建效果不佳，其成因有待于进一步研究。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects and influencing factors of hearing reconstruction after tympanic tympanoplasty. Methods: Seventy patients with otitis media who underwent surgical treatment at the Department of Otorhinolaryngology in our hospital from June 2008 to September 2019. All patients were treated with mastoidectomy and tympanoplasty, including 3 cases with upper tympanotomy and tympanoplasty. Two patients underwent bridge mastoidectomy+tympanoplasty, 25 patients underwent wall mastoidectomy + tympanoplasty, 40 patients underwent open mastoidectomy + tympanoplasty, and 24 patients underwent type I tympanoplasty. There were 42 cases of type II tympanoplasty and 4 cases of type III tympanoplasty; 29 cases of tympanic membrane repair with temporal muscle fascia, and 41 cases of tragus cartilage-chondral membrane complex. Calculate the air-bone gap before and after the operation, that is, the difference between the average values of air conduction and bone conduction at 4 frequencies of 500 Hz, 1 KHz, 2 KHz, and 4 KHz 20 dB is valid and belongs to the effective group, and more than 20 dB is invalid and belongs to the invalid group. Results: The number of effective cases was 42 and the number of invalid cases was 28. The effective rate was 60 %. The paired t-test and linear correlation analysis of the air-bone conduction spacing before and after the operation showed significant differences (P<0.05) and significant correlations (P<0.05). Postoperative hearing effects (ffective and ineffective) were used as dependent variables. Patient gender, patient age, duration of disease, follow-up interval, type of otitis media, type of surgery, type of tympanic formation, and repair materials were used as independent variables. Logisitic regression analysis was performed. Factors affecting the postoperative hearing effect were found (P>0.05). Conclusion: The majority of patients benefit from a one-stage hearing reconstruction, and some patients have poor hearing reconstruction. The cause of this need to be further studied. |
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