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  本文選題：慢性化膿性中耳炎　切入點(diǎn)：鼓室成形術(shù)　出處：《新疆醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討應(yīng)用自體耳屏軟骨鼓膜修補(bǔ)鼓并鼓室成形術(shù)治療慢性化膿性中耳炎(CSOM)患者的手術(shù)療效。方法：回顧性分析我院2010年1月之2011年12月49例鼓膜穿孔慢性化膿性中耳炎患者采用對(duì)用耳屏軟骨修補(bǔ)鼓膜、同時(shí)行鼓室成形術(shù)，，隨訪1年以上，復(fù)查純音測(cè)聽比較術(shù)前術(shù)后聽力的變化趨勢(shì)，并記錄患者日常生活中主觀聽力的改善。結(jié)果：49例中耳炎中耳炎患者中，手術(shù)后1個(gè)月后修補(bǔ)的鼓膜成活.術(shù)后隨訪1年余,除1耳鼓膜穿孔外其余耳均愈合,純音測(cè)聽示，氣導(dǎo)平均閾值行中耳探查+鼓室成性術(shù)后提高20dB以內(nèi)的患者（18耳）69.3%，行此手術(shù)方式患耳共有26耳占53.1%；行乳突根治+鼓室成形術(shù)+聽骨鏈重建術(shù)患耳23例，占46.9%，術(shù)后氣導(dǎo)平均閾值提高30-40dB以內(nèi)共有13耳，占56.5%，提高20dB、30dB各有3耳（26%）；術(shù)后主觀聽力改善者37耳，無(wú)變化6耳，較術(shù)前變差6耳，術(shù)后氣導(dǎo)提高30dB以內(nèi)時(shí)，77.4%患者（27耳）有明顯主觀聽力改善。結(jié)論：行鼓室成形術(shù)的中耳炎患者進(jìn)行術(shù)前術(shù)后比較純音測(cè)聽，并結(jié)合患者主觀聽力，可判斷鼓室成形術(shù)后聽力變化情況；用自體耳屏軟骨修補(bǔ)鼓膜的鼓室成形術(shù)后聽力改善明顯,使用的軟骨移植易成活，鼓膜支撐方面作用好,因而術(shù)后可有效的防止修補(bǔ)鼓膜的回縮，并聽骨的粘連，提高鼓室成形術(shù)的遠(yuǎn)期效果有一定的作用。
[Abstract]:Objective: to investigate the effect of tympanic membrane repair and tympanoplasty on chronic suppurative otitis media with tympanic membrane repair and tympanoplasty. Methods: 49 cases of chronic tympanic membrane perforation in our hospital from January 2010 to December 2011 were analyzed retrospectively. In patients with suppurative otitis media, the tympanic membrane was repaired with tragular cartilage. At the same time, tympanoplasty was performed, followed up for more than one year. The change trend of hearing was compared with pure tone audiometry before and after operation, and the improvement of subjective hearing in daily life of the patients was recorded. Results in 49 cases of otitis media patients with otitis media, The tympanic membrane repaired one month after operation survived. All ears healed except for 1 perforation of tympanic membrane after operation for more than one year. The mean threshold of air conduction was used to improve the tympanoplasty within 20dB after middle ear exploration in 18 ears (69.3 ears), 26 ears (53.1 ears) were treated with this operation, and 23 cases were treated with mastoid radical tympanoplasty and ossicular chain reconstruction. After operation, there were 13 ears (56.5%) within 30-40dB, 3 ears (26 ears) in 30 dB of 20 dB improvement, 37 ears with improvement of subjective hearing after operation, 6 ears with no change, 6 ears worse than those before operation, 3 ears with 30 dB increase of 20 dB, 6 ears with no change after operation, 3 ears with 30 dB increase of 20 dB, 6 ears with no change after operation. There was significant improvement in subjective hearing in 77.4% patients (77.4%). Conclusion: tympanoplasty was performed in patients with tympanoplasty with pure tone audiometry before and after operation, and combined with subjective hearing. The hearing changes after tympanoplasty can be judged. After tympanoplasty, the hearing of tympanic membrane repaired with autogenous tympanic cartilage can be improved obviously, the cartilage grafts used are easy to survive, and the tympanic membrane can be supported well. So it can effectively prevent the repair of tympanic membrane and ossicular adhesion and improve the long-term effect of tympanoplasty.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R764

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