完壁式乳突根治并鼓室成形术治疗慢性化脓性中耳炎的临床有效性分析

目的分析完璧式乳突根治并鼓室成形术治疗慢性化脓性中耳炎的临床有效性。方法前瞻性选取丹东市中心医院2018年1月至2019年6月接收的120例慢性化脓性中耳炎患者作为观察对象,按随机数字表法分为2组,对照组60例,采用开放式鼓室成形术;观察组60例,采用完璧式乳突根治并鼓室成形术。观察并记录2组临床疗效,术前、术后1年客观听力重建效果,术后1年主观听力改善率,住院时间,术后并发症发生情况及随访1年复发率。结果观察组临床总有效率为93.33%,显著高于对照组的75.00%,差异有统计意义(P<0.05)。观察组术前纯音气导阈、骨听阈及气骨导差值依次为(64.52±9.85)、(29.87±7.52)、(35.56±6.14)dB,术后1年依次为(28.64±5.43)、(20.13±5.85)、(8.59±3.33)dB;对照组术前纯音气导阈、骨听阈及气骨导差值依次为(64.76±10.08)、(30.23±6.89)、(36.17±5.94)dB,1年依次为(34.75±9.57)、(23.68±5.55)、(12.07±5.47)dB。2组患者术后1年纯音气导阈、骨听阈及气骨导差值均较术前明显降低,但观察组降低幅度更明显,差异有统计意义(P<0.05);观察组术后主观听力改善率为95.00%,高于对照组的73.33%,但差异无统计意义(P<0.05);观察组术后并发症总发生率为6.67%,明显低于对照组的21.67%,差异有统计意义(P<0.05);观察组住院时间为(8.85±2.04)d,随访1年复发率为1.67%,显著低于对照组的(13.59±5.91)d和18.33%,差异有统计意义(P<0.05)。结论完璧式乳突根治并鼓室成形术能够有效重建慢性化脓性中耳炎患者听力,降低术后并发症发生率和复发率,临床疗效显著,值得临床予以推广应用。

Analysis of clinical efficacy of mastoid radical resection combined with tympanoplasty in the treatment of chronic suppurative otitis media

Objective To analyze the clinical efficacy of complete mastoid radical resection combined with tympanoplasty in the treatment of chronic suppurative otitis media.Methods A tatol of 120 patients with chronic suppurative otitis media admitted to Dandong Central Hospital from January 2018 to June 2019 were selected as observation subjects,and were divided into two groups according to the random number table method.60 patients in the control group were treated with open tympanoplasty,and 60 patients in the observation group were treated with complete mastoid radical resection combined with tympanoplasty.The clinical efficacy,objective hearing reconstruction effect at preoperative and 1 year after operation,subjective hearing improvement rate at 1 year after operation,length of hospital stay,postoperative complications and recurrence rate of 1-year follow-up were observed.Results The total clinical effective rate of the observation group was 93.33%,significantly higher than that of the control group(75.00%),with statistically significant difference(P<0.05).In the observation group,the preoperative pure tone air conduction threshold,bone hearing threshold,and air bone conduction difference were(64.52±9.85),(29.87±7.52),(35.56±6.14)dB,1 year after operation were(28.64±5.43),(20.13±5.85),(8.59±3.33)dB;the preoperative pure tone air conduction threshold,bone hearing threshold and air bone conduction difference in the control group were(64.76±10.08),(30.23±6.89),(36.17±5.94)dB,1 year after operation were(34.75±9.57),(23.68±5.55),(12.07±5.47)dB.The differences of pure tone air conductance threshold,bone auditory threshold and air bone conductance between the two groups were significantly reduced after operation,but the reduction was more obvious in the observation group,and the difference was statistically significant(P<0.05).The postoperative subjective hearing improvement rate of the observation group was 95.00%,higher than that of the control group(73.33%),but there was no statistically significant difference between the two groups(P<0.05).The total incidence of postoperative complications in the observation group was 6.67%,significantly lower than that in the control group(21.67%),and the difference was statistically significant(P<0.05).The length of hospital stay in the observation group was(8.85±2.04)d,and the recurrence rate was 1.67% after 1-year follow-up,which was significantly lower than that in the control group(13.59±5.91)d and 18.33%,with statistically significant difference(P<0.05).Conclusion Complete mastoid radical resection combined with tympanoplasty can effectively reconstruct the hearing of patients with chronic suppurative otitis media,reduce the incidence of postoperative complications and recurrence,and has a significant clinical effect,which is worthy of clinical application.