目的:本研究的目的是比较使用和不使用抗生素软膏治疗慢性穿孔后的移植结果和术后感染。
方法:随机对照试验。
方法:将135例慢性穿孔随机分配到使用抗生素软膏组(UAO,n=68)或不使用抗生素软膏组(NAO,鼓膜成形术后n=67)。比较两组患者术后6个月的移植效果及术后感染情况。
结果:术后6个月,移植物感染率UAO组为4.4%,NAO组为10.4%,差异无统计学意义(P=0.312)。UAO组和NAO组移植成功率分别为92.6%和91.0%,差异无统计学意义(P=0.979)。在UAO组,3例化脓性耳分泌物患者尽管接受了氧氟沙星滴耳液和静脉抗生素治疗,但仍残留穿孔。在NAO组,6例化脓性耳分泌物导致残余穿孔,只有一个,轻度化脓性出院成功治疗和关闭。此外,术前(P=0.746)或术后(P=0.521)空骨间隙(ABG)值或平均ABG增益(P=0.745)均无显著组间差异.然而,在UAO组中有3例(4.4%)患者和在NAO组中有5例(7.5%)患者注意到颗粒性心肌炎,湿度最小但没有感染,差异无统计学意义(P=0.699)。
结论:在鼓膜成形术后使用和不使用抗生素软膏用于移植物侧方填塞两种方法对术后感染和移植物结局具有可比性。
OBJECTIVE: The objective of this study was to compare the graft outcome and postoperative infection of with and without the use of antibiotic ointment following myringoplasty for the treatment of chronic perforations.
METHODS: Randomized controlled trial.
METHODS: 135 chronic perforations were prospectively randomized to use of antibiotic ointment group (UAO, n = 68) or no use of antibiotic ointment group (NAO, n = 67) following myringoplasty. The graft outcomes and postoperative infection were compared among two groups at 6 months.
RESULTS: At postoperative 6 months, the graft infection rate was 4.4% in the UAO group and 10.4% in the NAO group, the difference was not significant (P = 0.312).The graft success rates were 92.6% in the UAO group and 91.0% in the NAO group, the difference was not significant (P = 0.979). In the UAO group, 3 patients with purulence ear discharge resulted in a residual perforation although they received ofloxacin ear drops and intravenous antibiotic therapy treatment. In the NAO group, 6 patients with purulence ear discharge resulted in a residual perforation, only one, with mild purulence discharge was successfully treated and closed. In addition, no significant between-group differences were observed pre- (P = 0.746) or post- (P = 0.521) operative air bone gap (ABG) values or mean ABG gain (P = 0.745). However, granular myringitis with minimal moistness but without infection has been noted in 3 (4.4%) patients in the UAO group and in 5 (7.5%) in the NAO group, the difference was not significant (P = 0.699).
CONCLUSIONS: Use and non-use of antibiotic ointments for lateral packing of graft are both comparable methods following myringoplasty for postoperative infection and graft outcomes.