医用生物蛋白胶应用于耳内镜下鼓膜修补术的临床疗效

Clinical efficacy of medical protein glue applied in otoscopic myringoplasty

摘要:

目的 分析医用生物蛋白胶应用于耳内镜下鼓膜修补术的临床疗效。方法 回顾性分析2022年10月－2023年10月该院收治的60例单纯鼓膜穿孔患者的临床资料，根据手术方法不同，将患者分为研究组和对照组，各30例。研究组术中使用医用生物蛋白胶粘合残余鼓膜和修补材料；对照组术中采用明胶海绵覆盖修补鼓膜。观察两组患者术后的鼓膜愈合情况（鼓膜愈合率、愈合时间、干耳时间和外耳道上下径）和并发症发生情况；于手术前后，采用纯音测听法（500、1 000、2 000、4 000 Hz），测量两组患者气导阈值，观察听力改善程度；采用视觉模拟评分法（VAS）评分，评估患者术后疼痛程度。结果 两组患者术后鼓膜愈合率、愈合时间、外耳道上下径和并发症发生率比较，差异均无统计学意义（P > 0.05）。研究组术后平均气导听阈明显低于对照组，差异有统计学意义（P < 0.05）。研究组术后干耳时间短于对照组，术后第1天疼痛VAS评分明显低于对照组，差异均有统计学意义（P < 0.05）。结论 医用生物蛋白胶应用于耳内镜下鼓膜修补术，可有效地降低气导听阈，缩短干耳时间，减轻患者疼痛，且不增加并发症发生率，值得临床推广应用。

Abstract:

Objective To analyze the clinical efficacy of medical protein glue applied in otoscopic myringoplasty.Methods A retrospective analysis was conducted on the clinical data of 60 patients with simple tympanic membrane perforation from October 2022 to October 2023 and divided into the study group and the control group according to different surgical methods, with 30 cases in each group. The study group used medical protein glue to bond the residual tympanic membrane and repair materials during the operation. In the control group, gelatin sponge was used to cover and repair the tympanic membrane during the operation. Observe the postoperative tympanic membrane healing conditions (tympanic membrane healing rate, healing time, dry ear time and upper and lower diameters of the external auditory canal) and the occurrence of complications in the two groups of patients; Before and after the operation, pure tone audiometry (500, 1 000, 2 000, 4 000 Hz) was used to measure the air conduction thresholds of the two groups of patients and observe the improvement in hearing. The visual analogue scale (VAS) score was used for scoring to evaluate the degree of postoperative pain in patients.Results There were no statistically significant differences in the postoperative tympanic membrane healing rate, healing time, upper and lower diameters of the external auditory canal, and the incidence of complications between the two groups of patients (P > 0.05). The average postoperative air conduction threshold in the study group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). The postoperative ear drying time of the study group was shorter than that of the control group, and the VAS score for pain on the first day after surgery was significantly lower than that of the control group. The differences were statistically significant (P < 0.05).Conclusion The application of medical protein glue in otoscopic myringoplasty can effectively decrease the air conduction hearing threshold, shorten the dry ear time, relieve the patient's pain, and does not increase the incidence of complications. It is worthy of clinical promotion and application.