陳楚亮 陳丙輝

[摘要] 目的 探討分析慢性中耳炎患者進(jìn)行耳內(nèi)鏡下微創(chuàng)鼓室成形術(shù)治療的效果。方法 方便選取2016年6月—2018年6月該院收治的80例慢性中耳炎患者，隨機分為觀察組與對照組各40例。對照組患者采用傳統(tǒng)顯微鏡下鼓室成形術(shù)進(jìn)行治療，觀察組患者采用耳內(nèi)鏡下鼓室成形術(shù)進(jìn)行治療。比較兩組患者手術(shù)時間、術(shù)中出血量、術(shù)后24 h疼痛程度、臨床療效及術(shù)后并發(fā)癥發(fā)生情況之間的差異。 結(jié)果 觀察組患者的手術(shù)時間（70.1±6.8）min明顯低于對照組的（95.4±8.2）min（t=15.021，P=0.000），術(shù)中出血量（10.7±3.0）mL明顯低于對照組的（27.6±5.8）mL（t=16.368，P=0.000）、術(shù)后24 h疼痛程度VAS評分（2.4±0.4）分明顯低于對照組的（4.1±0.9）分（t=10.917，P=0.000），臨床療效明顯優(yōu)于對照組（Z=2.332，P=0.020）。兩組患者術(shù)后皆未發(fā)生相關(guān)并發(fā)癥。 結(jié)論 耳內(nèi)鏡下微創(chuàng)鼓室成形術(shù)治療慢性中耳炎患者，能夠有效的縮短手術(shù)時間，降低術(shù)中出血量與術(shù)后疼痛程度，提高臨床治療效果，安全性較高，值得推廣應(yīng)用。

[關(guān)鍵詞] 慢性中耳炎;耳內(nèi)鏡;微創(chuàng);鼓室成形術(shù)

[中圖分類號] R764.21? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 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頗為常見的疾病，主要表現(xiàn)為鼓膜穿孔、患耳反復(fù)流膿、聽力下降等，嚴(yán)重者還可引起顱內(nèi)外并發(fā)癥的發(fā)生，需要及時進(jìn)行手術(shù)治療[1]。傳統(tǒng)術(shù)式常采用耳后切口下顯微鏡鼓室成形術(shù)，但該術(shù)式的創(chuàng)傷較大，手術(shù)視野差，預(yù)后較慢，難以滿足患者及家屬日益增長的臨床療效需求[2-3]。近年來，隨著精準(zhǔn)醫(yī)療觀念的提出與微創(chuàng)技術(shù)的不斷發(fā)展，耳內(nèi)鏡下微創(chuàng)鼓室成形術(shù)成為了一種新型術(shù)式，為慢性中耳炎治療提供了新的思路[4-5]。該研究中，方便選取2016年6月—2018年6月收治的80例慢性中耳炎患者，實施耳內(nèi)鏡下微創(chuàng)鼓室成形術(shù)，取得了較好的臨床治療效果?，F(xiàn)報道如下。