CAJ | 학술논문

目的探讨利用蛋膜海绵桥修复外伤性鼓膜穿孔的可行性及预防贴膜感染.方法选择1996年6月至2009年6月74例(75耳)外伤性鼓膜穿孔采用蛋膜海绵桥修复治疗中住院14d以上的中小穿孔贴膜治疗组(32耳)前瞻性观察研究.选择1991年1月至1995年12月在院未行贴膜治疗35耳中住院14日以上中小穿孔20耳作为历史对照组.结果贴膜治疗组32耳,30耳穿孔愈合,治愈率为93.8%.历史对照组20耳,13耳穿孔愈合,治愈率为65%,差异显著有统计学意义(93.8%比65%,P<0.05).贴膜组穿孔平均愈合时间为14d,对照组为27.5d,明显短于对照组,差异有统计学意义(14d比27.5d,P<0.05)两组继发感染率贴膜组为4%(3/75),未贴膜及贴膜前继发感染率为4.6%(5/108)两组相仿,贴膜组略低(P>0.05).近年笔者试用以酒精和氯霉素液浸泡部分去壳鲜蛋取蛋膜行贴膜疗法,为预防蛋膜贴膜继发感染开拓一条新途径.结论蛋膜明胶海绵桥可起到支架、营养、粘贴、修补、隔离保护作用,蛋膜修复外伤性鼓膜穿孔可显著提高疗效.应用酒精、氯霉素液浸泡去壳鲜蛋对预防贴膜感染有益.
목적탐토이용단막해면교수복외상성고막천공적가행성급예방첩막감염.방법선택1996년6월지2009년6월74례(75이)외상성고막천공채용단막해면교수복치료중주원14d이상적중소천공첩막치료조(32이)전첨성관찰연구.선택1991년1월지1995년12월재원미행첩막치료35이중주원14일이상중소천공20이작위역사대조조.결과첩막치료조32이,30이천공유합,치유솔위93.8%.역사대조조20이,13이천공유합,치유솔위65%,차이현저유통계학의의(93.8%비65%,P<0.05).첩막조천공평균유합시간위14d,대조조위27.5d,명현단우대조조,차이유통계학의의(14d비27.5d,P<0.05)량조계발감염솔첩막조위4%(3/75),미첩막급첩막전계발감염솔위4.6%(5/108)량조상방,첩막조략저(P>0.05).근년필자시용이주정화록매소액침포부분거각선단취단막행첩막요법,위예방단막첩막계발감염개탁일조신도경.결론단막명효해면교가기도지가、영양、점첩、수보、격리보호작용,단막수복외상성고막천공가현저제고료효.응용주정、록매소액침포거각선단대예방첩막감염유익.
Objective To study the effectiveness of repairing post-traumatic tympanic membrane perforation by egg membrane-sponge bridge and prevent to stick egg membrane secondary infection. Methods Seventy-four patients(75 ear), with post-traumatic tympanic membrane perforation admitted to the SongYuan Center Hospital, from June, 1996 to June, 2009. prospective observational study the method of repairing by egg membrane-sponge bridge, the patients in stick membrane group(32 ears) of middl-Little perforation, in hospital over 14days. A cohort of 35 ears with matched disease history admitted during January, 1991 to December, 1995. were enrolled as control group(20 ears)had been treated with routine therapy. Results In the stick membrane grorp the cured rate was much higher than that of control group(93.8%vs.65%, P<0.05). The perforation healed time in the stick memibrane group was significantly reduced than that in control group (14d vs .27.5d, P<0.05).But secondary infection rate were similar, there were no significant defference between the two groups(4%vs.4.6%, P>0.05.Recently author tricd to soak egg membrane in alcohol and chloromycetin solution repairing post-traumatic membrane perforation 2 cases were cured,on prevent stick egg membrane secondary infection to open a new road. Conolusion The egg membrane gelatin sponge bridge have support.nutrition. paste .isolation. protective effectiveness. The post-traumatic tympanic membrane perforation was repaired by egg membrane-sponge. It may be improve cure rate obviously. Egg memberane soak in alcohol and chloromycetin solution may prevent to stick membrane secondary infection.