肝素明胶海绵治疗外伤性鼓膜穿孔的临床观察

目的 观察肝素明胶海绵治疗外伤性鼓膜穿孔的临床效果.方法 将浙江省舟山市妇幼保健院耳鼻喉科2010年1月～2011年12月收治的外伤性鼓膜穿孔患者72例(76耳),分为对照组35例(36耳)及观察组37例(40耳),对照组给予常规保守治疗,观察组给予肝素明胶海绵治疗,观察两组的临床治疗效果.结果 观察组愈合率为95.0％,对照组愈合率为55.6％,观察组的合率明显高于对照组,差异有统计学意义(P＜0.05);观察组患者鼓膜愈合时间为(14.6±2.2)d,对照组患者鼓膜愈合时间为(35.6±2.7)d,差异有统计学意义(P＜0.05);对照组和观察组治疗前语频区气导弹听阈为(20.4±5.6)、(21.7±5.5)dB,差异无统计学意义(P＞0.05);对照组和观察组治疗后语频区气导弹听阈为(22.5±6.5)、(27.4±7.8)dB,差异有统计学意义(P＜0.05).结论 临床中采取肝素明胶海绵治疗外伤性鼓膜穿孔效果显著,愈合较快,且治疗方法也比较简单,值得临床中应用与推广.

Clinical observation of heparin gelatin sponge in the treatment of trau- matic tympanic membrane perforation

Objective To observe the clinical effect of Heparin gelatin sponge in the treatment of traumatic tympanic membrane perforation. Methods 72 cases （76 ears） of traumatic tympanic membrane perforation from January 2010 to December 2011 in Maternal and Child Health Hospital of Zhoushan City were selected and divided into control group with 35 cases （36 ears） and observation group with 37 cases （40 ears）; patients in control group were treated with conventional conservative treatment, while patients in observation group were treated with heparin gelatin sponge treatment; the clinical effect were observed. Results The healing rate of observation group was 95.0%, the healing rate of control group was 55.6%, the healing rate in observation group was higher than that in control group, the difference was statistically significant （P 〈 0.05）. The tympanic membrane healing time of observation group were （14.6±2.2） d, tympanic membrane healing time of control group were （35.6±2.7） d, the difference was statistically significant （P 〈 0.05）. The zone air missiles speech frequency hearing threshold in control group and observation group before treatment were （20.4±5.6）, （21.7±5.5） dB respectively, the difference was statistically significant （P 〈 0.05）; the zone air missiles speech frequency hearing threshold in control group and observation group after treatment were （22.5±6.5）, （27.4±7.8） dB, the difference was statistically significant （P 〈 0.05）. Conclusion The clinical effect of gelatin sponge in the treatment of traumatic tympanic membrane is remarkable, the healing is fast, and the treatment method is relatively simple, it is worthy of clinical application and promotion.