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目的:探讨外伤性鼓膜穿孔手术治疗的必要性及临床意义。方法:134例患者(134耳)中男71例,女63例,年龄7～65岁,平均32岁,在显微镜明视下了解鼓膜穿孔情况,分别实施急诊对合复位术、单纯鼓膜贴补术、切除残缘鼓膜贴补术。其中,急诊对合复位术57耳,单纯鼓膜贴补术56耳,切除残缘鼓膜贴补术21耳。各组间率的比较用检验。结果:单纯鼓膜贴补术在15d一期愈合37耳,治愈率为66.1%,切除残缘贴补术16耳,治愈率为76.2%,急诊对合复位术在15d全部一期愈合,治愈率为100.0%。急诊对合复位术与单纯鼓膜贴补术或切除残缘贴补术比较治愈率都有显著性差异(P<0.01)。结论:急诊对合复位术明显优于单纯鼓膜贴补术和切除残缘鼓膜贴补术,可使穿孔全层愈合,愈合后原穿孔痕迹不明显,有效提高了治愈率和缩短愈合时间,保持了鼓膜原有的锥状形态。但它有使用的局限性,严格地说它只适用于3d以内的外伤性鼓膜穿孔。
Objective: To investigate the necessity and clinical significance of surgical treatment of traumatic tympanic membrane perforation. Methods: There were 71 males and 63 females in 134 cases (134 ears), aged from 7 to 65 years (average 32 years old). The tympanic membrane perforation was observed under the microscope. , Removal of residual tympanic membrane paste surgery. Among them, the emergency treatment of combined reduction of 57 ears, simple tympanic membrane repair 56 ears, removal of residual tympanic membrane paste surgery 21 ears. Comparison of rates among groups was tested. Results: The simple tympanic membrane repair healed 37 ears in the first 15d, the cure rate was 66.1%. The removal rate was 76.2% and the cure rate was 76.2%. The cure rate was 100.0 %. There was a significant difference between the two groups in the rate of emergency curettage and curettage (P <0.01). CONCLUSION: The combination of emergency repair and repositioning is superior to simple tympanic membrane repair and resection of residual tympanic membrane, which can heal the full-thickness perforation. The original perforation marks are not obvious after healed, which effectively improves the cure rate and shortens the healing time, keeps the tympanic membrane The original cone shape. But it has the use of limitations, strictly speaking, it only applies to traumatic tympanic membrane perforation within 3d.