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1、临床耳鼻咽喉头颈外科杂志2007年5月第21卷第10期·441·分期鼓室成形术临床疗效观察111李克勇赵宁军孙雅静[摘要]目的:探讨分期鼓室成形手术治疗慢性化脓性中耳炎和胆脂瘤病中耳炎的临床特点和疗效。方法:回顾性分析132耳用该方法治疗的患者(分期成形组),并与同期325耳一期成形的患者(一次成形组)做疗效比较。以术后听力提高程度(ABG值)、胆脂瘤再发率、鼓膜再穿孔率和术后不干耳率为疗效指标。结果:分期鼓室成形组ABG值28.4dB,鼓膜再穿孔率1.5%,胆脂瘤复发率0%,术后不干耳率0%;一次成形组ABG值21.3dB,
2、鼓膜再穿孔率2.2%,胆脂瘤再发率4.0%,术后不干耳率1.2%。结论:分期成形组的术后听力提高程度、胆脂瘤复发率显著优于一次成形组。鼓膜再穿孔率和术后不干耳率差异无统计学意义。所以利用分期手术可有效地挽救和提高大部分慢性化脓性中耳炎患者的术后听力。[关键词]中耳炎,化脓性;胆脂瘤,中耳;鼓室成形术[中图分类号]R764.21[文献标志码]A[文章编号]100121781(2007)1020441203ClinicaltherapeuticeffectsofstagingtympanoplastyLIKeyongZHAONin
3、gjunSUNYajing(DepartmentofOtorhinolaryngology2HeadandNeckSurgery,ShanghaiJiaotongUniversityAffiliatedFirstPeople'sHospital,Shanghai,200080,China)AbstractObjective:Toexplorethecliniccharacteristicandcurativeeffectofstagingtympanoplastyforchro2nicsuppurativeotitismedi
4、aandcholesteatomaotitismedia.Method:Curativeeffectsof132patientscuredbystag2ingtympanoplastyand325patientscuredbynostagingtympanoplastywereretrospectivelyanalyzed.CurativeeffectsincludeABGvalue(thereducedvalueofair2boneconductgapsafteroperation),recrudescenceofchol2
5、esteatoma,tympanicmembranereperforationandwetearafteroperation.Result:Instagingtympanoplastygroup,ABGis28.4dB,rateoftympanicmembranereperforationis1.5%,recrudescenceofcholesteatomais0%andrateofwetearafteroperationis0%.Innostagingtympanoplastygroup,ABGis21.3dB,rateof
6、tympanicmem2branereperforationis2.2%,recrudescenceofcholesteatomais4.0%andrateofwetearafteroperationis1.2%.Conclusion:TheABG,therateofrecrudescenceofcholesteatomainstagingtympanoplastygroupismuchbetterthanthatinnostagingtympanoplastygroup.Tympanicmembranereperforati
7、onandwetearafteroperationratehavenosignificantdifferenceinstatisticbetweentwogroups.Wecanconcludethatstagingoperationswillmain2tainandimprovehearinglevelmoreeffectivelycomparetonostagingoperation.KeywordsOtitismedia,suppurative;Cholesteatoma,middleear;Tympanoplasty随
8、着生活质量的提高,在治疗中耳炎方面,患炎患者,剔除随访资料不完整的148耳(一次成形者对提高和保持听力提出了更高的要求。大多数113例,分期成形35例)和单纯鼓膜修补术39例,慢性化脓性中耳炎和胆脂瘤性中耳炎患者都可以共457耳进入统计,随访率70.1%。所有患者随在清除病灶
