慢性化脓性中耳炎患者术中植入钛人工听骨 对听力变化的临床疗效研究

Hearing changes in patients with chronic suppurative otitis media treated with titanium artificial auditory ossicles

摘要:

目的 研究钛人工听骨在慢性化脓性中耳炎患者手术听骨链修复中的效果及患者听力变化情况。 方法 选取2013 年6 月-2015 年6 月就诊的40 例慢性化脓性中耳炎患者。随机单盲取法分为两组，对照组20 例采用鼓室成形术进行修复，观察组在对照组基础上联合应用钛人工听骨进行听骨链的重建。手术前后，采用 纯音测听方式检测分析患者的骨导听力、气导听力、气骨导差的情况，并对患者并发症状况进行分析。结果 两组术后2、6、12 及24 个月同频率与术前骨导听力比较，差异无统计学意义（P >0.05），观察组术后2、6、 12 及24 个月不同检测频率下气导听力与同组术前及对照组比较，差异有统计学意义（P <0.05），观察组低于 同组术前及对照组。两组出院时气导听力及气骨导差均低于术前，差异有统计学意义（P <0.05）；出院时观 察组听力改善有效率为85.00%，气骨导差改善有效率为75.00%，对照组听力改善有效率为55.00%，气骨导差 改善有效率为50.00%，两组比较，差异有统计学意义（χ2=4.286 和3.956，P =0.038 和0.047），观察组高于对 照组。结论 钛人工听骨可改善慢性化脓性中耳炎患者的听力状况，手术效果及术后恢复良好，值得广泛推广。

Abstract:

Objective To study the clinical curative effect of titanium prosthesis on hearing changes in patients with chronic suppurative otitis media. Methods Forty patients with chronic suppurative otitis media were enrolled from June 2013 to June 2015. Using randomized single-blind extraction they were divided into two groups. The control group (20 cases) was treated by tympanoplasty. The observation group was reconstructed with titanium artificial bone on the basis of the control group. Before and after operation, pure tone audiometry was used to detect and analyze the patients' bone conduction hearing, air conduction hearing and air-bone gap (ABG), and the complication status of the patients was also analyzed. Results In both groups, the bone conduction hearing 2, 6, 12 and 24 months after operation was not significantly different from that at the same frequency before operation (P > 0.05). The air conduction hearing in the observation group 2, 6, 12 and 24 months after operation was lower than that before operation and that of the control group at the same frequency and same time (P < 0.05). At discharge, the effective rate of hearing improvement in the observation group was 85%, higher than 55% in the control group (P < 0.05), and the effective rate of ABG improvement was 75%, which was higher than 50% of the control group (χ2 = 4.286 and 3.956, P = 0.038 and 0.047). Conclusions Titanium prosthesis can significantly improve the hearing status of the patients with chronic suppurative otitis media, the effect of the operation and the postoperative recovery are good. It is worthy of popularization.