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目的:探讨分期鼓室成形手术治疗慢性化脓性中耳炎和胆脂瘤病中耳炎的临床特点和疗效。方法:回顾性分析132耳用该方法治疗的患者(分期成形组),并与同期325耳一期成形的患者(一次成形组)做疗效比较。以术后听力提高程度(ABG值)、胆脂瘤再发率、鼓膜再穿孔率和术后不干耳率为疗效指标。结果:分期鼓室成形组ABG值28.4dB,鼓膜再穿孔率1.5%,胆脂瘤复发率0%,术后不干耳率0%;一次成形组ABG值21.3dB,鼓膜再穿孔率2.2%,胆脂瘤再发率4.0%,术后不干耳率1.2%。结论:分期成形组的术后听力提高程度、胆脂瘤复发率显著优于一次成形组。鼓膜再穿孔率和术后不干耳率差异无统计学意义。所以利用分期手术可有效地挽救和提高大部分慢性化脓性中耳炎患者的术后听力。
Objective: To investigate the clinical features and efficacy of phased tympanoplasty in the treatment of chronic suppurative otitis media and cholesteatoma otitis media. Methods: A retrospective analysis of 132 ears with this method of treatment of patients (staging group), and with the same period 325 ears a form of patients (a forming group) to do the curative effect comparison. The improvement of postoperative hearing (ABG value), cholesteatoma recurrence, rectal perforation rate and postoperative dry ear rate indicators. Results: ABG of staging tympanoplasty group was 28.4dB, rectal perforation rate was 1.5%, cholesteatoma recurrence rate was 0%, postoperative dry ear rate was 0%; ABG value of primary forming group was 21.3dB, tympanic membrane re-perforating rate was 2.2% Cholesteatoma recurrence rate of 4.0%, postoperative dry ear rate of 1.2%. Conclusion: The degree of postoperative hearing enhancement in choledochoic group is significantly better than that in primary forming group. The tympanic membrane perforation rate and postoperative dry ear rate difference was not statistically significant. Therefore, the use of staging surgery can effectively save and improve postoperative hearing in most patients with chronic suppurative otitis media.