CAJ | 학술논문

①目的观察直接伤和间接伤致鼓膜穿孔的早期形态学特点，为鉴定鼓膜穿孔的致伤方式提供临床指导。②方法选取在我院就诊的439例外伤性鼓膜穿孔患者的临床资料进行回顾性分析。③结果直接伤鼓膜穿孔34例（均为单耳鼓膜穿孔），12例穿孔为类圆形，11例为不规则形，其它共11例；间接伤鼓膜穿孔405例，共442耳，其中153耳鼓膜穿孔为不规则形，132耳为梭形，108耳为裂隙状，其它49耳。直接伤鼓膜穿孔常为类圆形或不规则形，穿孔缘多内翻，穿孔周围出血较多，可有外耳道的损伤；间接伤所致穿孔常为不规则形、梭形或裂隙状，穿孔缘锐利，多外翻，穿孔周围出血较少，常不伴有外耳道的损伤。④结论根据直接与间接伤鼓膜穿孔的形态、穿孔缘的状态、边缘的出血情况等形态学特点可鉴别外伤性鼓膜穿孔的致伤方式。
①목적관찰직접상화간접상치고막천공적조기형태학특점，위감정고막천공적치상방식제공림상지도。②방법선취재아원취진적439예외상성고막천공환자적림상자료진행회고성분석。③결과직접상고막천공34례（균위단이고막천공），12례천공위류원형，11례위불규칙형，기타공11례；간접상고막천공405례，공442이，기중153이고막천공위불규칙형，132이위사형，108이위렬극상，기타49이。직접상고막천공상위류원형혹불규칙형，천공연다내번，천공주위출혈교다，가유외이도적손상；간접상소치천공상위불규칙형、사형혹렬극상，천공연예리，다외번，천공주위출혈교소，상불반유외이도적손상。④결론근거직접여간접상고막천공적형태、천공연적상태、변연적출혈정황등형태학특점가감별외상성고막천공적치상방식。
Objective To observe early stage morphosis of the traumatic tympanic membrane per‐foration caused by direct or indirect injury ,and to provide clinical guidance for identifying the injured manner of tympanic membrane perforation .Methods Clinical data of 439 patients with traumatic tym‐panicmembraneperforationwereanalyzedretrospectively.Results 34casesoftympanicmembrane perforation caused by direct injury (both for single ear) ,12 cases of perforation close round ,11 cases of irregular shape ,the other a total of 11 cases ;405 cases of tympanic membrane perforation caused by in‐direct injury ,a total of 442 ears ,153 tympanic membrane perforation of irregular shape ,132 ears of spindle shape ,108 ears of crack -like ,the other 49 ears .The tympanic membrane perforation usually close round or irregular shape caused by direct injury ,more introversive perforated edge ,surrounding perforation bleeding more ,may with the damaged external auditory canal ;The tympanic membrane per‐foration caused by indirect injury often irregular ,spindle or crack-like ,perforated edge sharp ,more ex‐troversive ,less bleeding around the perforation ,frequently with the no damaged external auditory canal . Conclusion Direct and indirect injury tympanic membrane perforation patterns ,perforated edge of the state ,the bleeding edge morphological characteristics can be identified the injured way of traumatic tympanic membrane perforation .