双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响

黄恒; 余文兴; 税磊; 何刚; 杨森

双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响

遂宁市中心医院耳鼻喉科

基金项目:

基金：四川省科技厅科技支撑计划 (2012SZ00319);

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出版历程
- 收稿日期: 2018-02-03

Effect of Binocular Surgery Microscope and Otoendoscope on Perioperative indexes, Hearing recovery and Complications in the Patients with Artificial Stapes Surgery

Funds:

基金：四川省科技厅科技支撑计划 (2012SZ00319);

摘要

摘要: 目的观察双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响.方法选取遂宁市中心医院行人工镫骨手术患者160例, 依据术中放大设备差异分为A组 (n=80) 与B组 (n=80) , A组采用双目手术显微镜, B组采用耳内镜, 比较2组围术期指标 (手术时间、术后苏醒时间、住院时间) , 并观察2组术前与术后3个月听力变化、并发症情况.结果 A组手术时间与术后苏醒时间均明显短于对照组 (P<0.05) , 2组住院时间比较差异无统计学意义 (P>0.05) ;术后3个月, 2组气导听阈、气骨导间距均较术前明显降低 (P<0.05) , 且组间比较差异无统计学意义 (P>0.05) ;2组术后并发症总发生率比较差异无统计学意义 (P>0.05) , 所有并发症经对症处理后完全消失.结论与耳内镜相比, 双目手术显微镜下行人工镫骨手术, 手术时间短, 术后麻醉苏醒快, 2种放大设备在恢复患者听力方面的疗效相当, 且并发症均较少.
- 双目手术显微镜 /
- 耳内镜 /
- 人工镫骨手术 /
- 听力恢复 /
- 并发症
Abstract: Objective To observe the effect of binocular surgery microscope and otoendoscope on perioperative indexes, hearing recovery and complications in the patients with artificial stapes surgery. Me thods A total of 160 patients undergoing artificial stapes surgery in the hospital were recruited and were divided into group A (n = 80) and group B (n = 80) according to different magnifying devices used during the surgery. The binocular surgery microscope was used in group A while the otoendoscope was used in group B. The perioperative indexes (surgical time, postoperative recovery time and hospital stay) were compared between the two groups. The changes of hearing and complications in the two groups before surgery and at 3 months after the surgery were observed.Re s ults The surgical time and postoperative recovery time of group A were significantly shorter than those of group B (P < 0.05) . There was no significant difference in hospital stay between the two groups (P > 0.05) . Three months after surgery, the air mediated hearing threshold and air bone gap in the two group significantly decreased (P< 0.05) , but there was no significant difference between the two groups (P > 0.05) . There was no significant difference in the total incidence of postoperative complications between the two groups (P > 0.05) , and all the complications completely disappeared after treatment. Conclus ion Compared with otoendoscope, the time of artificial stapes surgery under binocular surgery microscope is shorter and patients can recover quickly fromanesthesia after surgery. Effects of the two magnifying devices are similar in terms of hearing recovery and with few complications.
- Binocular surgery microscope /
- Otoendoscope /
- Artificial stapes surgery /
- Hearing recovery /
- Complications

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参考文献(26)

[1]孙建军.听骨链修复与功能重建的理论与实践[J].临床耳鼻咽喉头颈外科杂志, 2014, 28 (4) :215-218.
[2]杨凤, 刘阳, 孙建军, 等.先天性前庭窗及相关结构畸形的影像诊断及个性化手术[J].中华耳科学杂志, 2015, 13 (1) :120-125.
[3]吴红莲, 高献芳, 梁长虎, 等.耳硬化症的高分辨率CT诊断[J].医学影像学杂志, 2016, 26 (1) :22-24.
[4]	[4]CHRISTIAN GLDNER, ISABELL DIOGO, EVA BERND, et al.Visualization of anatomy in normal and pathologicmiddle ears by cone beam CT[J].European Archives of Oto-Rhino-Laryngology, 2017, 274 (2) :364-367.
[5]邓白茹, 陈燕萍, 易云平, 等.耳硬化症的HRCT征象分析[J].医学影像学杂志, 2015, 25 (4) :604-607.
[6]	[6]FISCH U.Stapedotomy versus stapedectomy[J].American Journal of Otology, 1982, 4 (2) :112.
[7]张宏征, 蔡洁青, 许木清, 等.中耳手术中鼓索神经的保护与效果分析[J].听力学及言语疾病杂志, 2017, 25 (4) :382-384.
[8]马坤, 侯昭晖, 张欣欣.镫骨修正术的疗效分析[J].中华耳科学杂志, 2015, 13 (2) :309-311.
[9]侯炜, 杨勇智.可吸收止血海绵术后填塞对耳科手术患者耳痛程度和干耳时间的影响[J].湖南师范大学学报 (医学版) , 2017, 14 (4) :16-18.
[10]王铮, 谷佳, 韩涛, 等.人工耳蜗植入术中客观检测技术的分析[J].解放军医药杂志, 2015, 27 (6) :49-52.
[11]夏寅.听骨链成形术与镫骨成形术-House与Fisch比较[J].中华耳科学杂志, 2017, 15 (1) :14-19.
[12]王凯, 俞杰, 李幼珍, 等.手术治疗鼓室硬化症[J].中国耳鼻咽喉头颈外科, 2014, 21 (1) :26-28.
[13]曾婉婷, 李洪涛, 谭韵, 等.晚期耳硬化症CO_2激光辅助镫骨开窗术疗效的初步观察[J].中国耳鼻咽喉头颈外科, 2016, 23 (7) :399-401.
[14]周韧, 林晨, 倪玉苏.人工镫骨植入手术术中配合及疗效分析[J].听力学及言语疾病杂志, 2014, 10 (6) :239-240.
[15]赵轶, 吴雅琴, 陈正侬, 等.智能CO2激光在耳硬化症手术中的应用[J].听力学及言语疾病杂志, 2016, 24 (4) :340-342.
[16]黄婷.镫骨底板开窗人工镫骨植入术的护理配合[J].中华现代护理杂志, 2014, 20 (29) :3735-3736.
[17]张纪帅, 王若雅, 韩维举.外伤性镫骨骨折的诊断及手术治疗[J].听力学及言语疾病杂志, 2015, 23 (1) :25-28.
[18]郝欣平, 陈树斌, 于子龙, 等.耳道内径路激光辅助下微创镫骨手术治疗耳硬化症的临床研究[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (5) :353-356.
[19]王炜, 徐家兔, 戴国平, 等.耳内窥镜在耳硬化症人工镫骨手术中的应用研究[J].中国内镜杂志, 2017, 23 (2) :58-61.
[20]赵宇, 郑永波, 娄麟, 等.耳内镜和显微镜下镫骨手术的比较[J].中华耳科学杂志, 2017, 15 (4) :408-411.
[21]叶静, 秦学玲, 王力红, 等.中耳炎手术中保留完整外耳道皮瓣的临床研究[J].西部医学, 2010, 22 (4) :719-720.
[22]	[22]KING E B, SHEPHERD R K, BROWN D J, et al.Gentamicin applied to the oval window suppresses vestibular function in guinea pigs[J].Journal of the Association for Research in Otolaryngology, 2017, 18 (2) :314-317.
[23]	[23]AYDIN MOHAMMADI, NICHOLAS JUFAS, PHILIP SALE, et al.Micro-CT analysis of the anatomical characteristics of the stapedial annular ligament[J].Anatomical Science International, 2017, 92 (2) :225-228.
[24]	[24]VINCENT PITIOT, RUBEN HERMANN, STPHANE TRINGALI, et al.Revision stapes surgery for lysis of the long process of the incus:comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis[J].European Archives of Oto-Rhino-Laryngology, 2016, 273 (9) :1785-1788.
[25]宗海亮, 许洪升, 马冲, 等.神经内镜及显微镜下切除颅底中线区脑肿瘤的临床价值[J].西部医学, 2015, 27 (11) :1641-1643.
[26]	[26]HESSERGA J, BLHJ E, VASSBOTN F S.Cartilage island on stapes:autologous PORP in the hypoventilated middle ear[J].European Archives of Oto-Rhino-Laryngology, 2017, 274 (4) :1859-1864.

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