| Objective:To observe the clinical therapeutic effect of treating traumatic perforation of tympanic membrane by using albumin,and to explore a simple,safe and effective method to treat traumatic perforation of the tympanic membrane.Methods:Prospective randomized study of 80 outpatients or hospitalized pations with traumatic tympanic membrane perforation who were enrolled in the Department of Otolaryngology at the Yan'an University Affiliated Hospital from October 2015 to January 2017.There were 31 males and 49 females,aged from 6 to 60 years,median age 32(11)years old,Left ear 54 cases,right ear 26 cases.The patients with traumatic tympanic membrane perforation were randomly divided into processing group(n=40)and control group(n=40),according to the size of perforation of tympanic membrane,pations in each group were divided into small perforation group(perforation maximal diameter <3mm),medium perforation group(perforation maximum diameter 3~5mm),and large perforation group(perforation diameter> 5mm),the pations in processing group were treated with albumin treatment once every other day,recording ear endoscopic data and saving it;while the pations in control group were used the traditional drying method and checked once every three days to the hospital;two groups were oral anti-inflammatory drugs,even for 3 days,keep the Eustachian tube patency,ears not enter the water and keep dry.To avoid hard to blow your nose and prevent colds.All patients were followed up in two months,Observed and recorded tympanic membrane healing situation,healing time,hearing gain and infection.Efficacy criteria:Healing: perforation healing completely,healing area tympanic membrane color,shape is closed to normal,and hearing back to normal;Effective: tympanic membrane perforation shrink,not completely healed,hearing to improve partly;Invalid: no significant change in perforation,hearing improvement is not obvious.Results:1.Perforation healing tympanic membrane which treated by albumin is very similar to the normal tympanic membrane,and the transparency can be,no scars;2.The total perforation rate of the treatment group in 1 month and 2 months:Traumatic tympanic membrane perforation in 1 month,the total healing rate was 57.5%(23/40)in the treatment group and 30%(12/40)in the observation group,this is ststistical significance between the healing ratios of the teatment group and the observation group(P <0.05).In 2 month,the total healing rate was 85.0%(34/40)in the treatment group and 55%(22/40)in the observation group,the difference was ststistically(P <0.01).Grouped by the perforated size of tympanic membrane:In medium perforation and in large perforation,the healing rates were 66.7% and 30.0% in the treatment group and 16.7% and 0 in the observation group respectively in first month.The difference was statistically significant(P <0.05);In second month,The healing rate was 83.3% and 70.0% in the treatment group,while in control group was 33.3% and 12.5%,the difference was statistically significant(P <0.05).The healing rate was 66.7 in the small perforation group in first month,The control group was 50%;In second month when the treatment group healing rate was 94.4%,the control group was 85.0%,the statistical difference were not statistically significant(P> 0.05).3.The average healing time difference between the two groups:The average healing time of the treatment groups was significantly shorter than that of the observation group at small,medium ang large perforation groups,there were obvios difference(P <0.05).4.Hearing gain situation:There was no significant difference in the average hearing threshold between the two groups(P> 0.05).However,after the tympanic membrane perforation hears,the average hearing threshold of the two groups was statistically significant(P <0.05).The average hearing threshold of the treatment group was higher than that of the control group,indicating:Albumin therapy is beneficial to the improvement of traumatic tympanic perforation hearing problems.Conclusion:1.Albumin can significantly promote the healing of traumatic perforation of the tympanic membrane,improve the healing rate,shorten the healing time,and the healing of the tympanic membrane close to the normal color of the tympanic membrane.After treatment and before the hearing is basically consistent with the hearing.2.Albumin can be used as a cure for traumatic tympanic membrane perforation economy,simple,safe,effective method and be promoted in clinical practice,not only can reduce the economic burden of patients,but also to avoid the surgery to patients with greater trauma and the technology can also in the primary hospital to promote universally. |
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