完壁式乳突切除术联合鼓室成形术治疗慢性化脓性中耳炎的疗效分析

摘要

Objective To analyze the curative effect and hearing improvement of canal wall up type radical mastoidectomy (CWUM) and tympanoplasty in the treatment of chronic suppurative otitis media (CSOM).Methods One hundred and thirty patients with CSOM were divided into the research group (treated by CWUM and tympanoplasty) and the control group (treated by routine surgery).All patients were followed up for 24 months after surgery.The pure tone hearing before and after the treatment,postoperative improvement of subjective hearing,the average dry ear time and the complications were compared between the two groups.Results Twenty-four months after the surgery,the pure tone hearing of the two groups were significantly decreased (P ＜ 0.05),and there was a significant difference between the two groups postoperatively (P ＜ 0.05).The improvement of subjective hearing in the research group was significantly better than that in the control group (P ＜ 0.05).The dry ear time of the research group was longer than that of the control group (P ＜ 0.05).There was no significant difference in the incidence of postoperative complications between the two groups (P ＞ 0.05).Conclusions CWUM combined with tympanoplasty was effective in the treatment of CSOM which could obviously improve the patients' hearing,and it was safe and feasible.%目的 评估完壁式乳突切除术(CWUM)联合鼓室成形术治疗慢性化脓性中耳炎(CSOM)的效果.方法 130例CSOM患者按照手术方式不同分为研究组(完壁式乳突切除术+鼓室成形术)与对照组(开放式乳突切除术+鼓室成形术),每组各65例.术后随访24个月,比较2组患者治疗前后纯音听力、术后主观听力改善、平均干耳时间及并发症情况.结果 研究组与对照组术后24个月的纯音听阈阈值分别比术前降低22.59 dB和11.42 dB;组内手术前后及组间术后听力改善比较差异均有统计学意义(P值均＜0.05).研究组术后24个月主观听力改善优于对照组(P＜0.05).研究组与对照组术后干耳所需时间分别为49.16 d和36.95 d,组间差异具有统计学意义(P＜0.05).2组术后并发症发生率比较差异无统计学意义(P＞0.05).结论 CWUM联合鼓室成形术治疗CSOM对于符合适应证的患者,能够完整清除病灶,改善患者听力,疗效确切.手术医师需要根据患者病变情况合理选择CWUM或开放式乳突切除术.