| Objectives The effect of AFGF stanching satin on tympanic membrane repair was studied by applying AFGF stanching satin on tympanic membrane repair.Methods In a cohort study,60 patients admitted to Tangshan Workers’ Hospital from October 2018 to October 2020 were selected and randomly divided into AFGF bleeding twill intervention group(n = 30)and gelatin sponge intervention group(n = 30).The method of repairing tympanic membrane under Ear endoscope: preoperative preparation good cotton ball to weighing scales,under general anesthesia,the preparation of the graft:A longitudinal incision was made on the medial side of the free margin of the operative ear,and then the membrane of cartilage was separated from the subcutaneous tissue and divided into left and right margins and lower margins along the entire length.The cartilage and epithelium were incised separately so that the upper edge of the cartilage was maintained at about 3 mm.The cartilage was trimmed according to the size and shape of the perforation,so that the membrane of cartilage was about 1-2 mm wider than the cartilage,and the surgical incision was closed with absorbable sutures.Endoscope through external auditory canal into the middle ear,use small microscopic hook to the edge of the perforation of separation,Pierce to form a new wound,according to the size of the tympanic membrane perforation to shear and replacement of stents,lifting a plane flap,moved to the tympanic membrane and repairing tympanic membrane perforation position,will flap were applied in the external auditory canal,to weigh the cotton ball to stop bleeding,Different materials were pasted on the edge of tympanic membrane perforation and external auditory canal flap,and iodine gauze was used to fill it,and thick cotton balls were used to compress and fill the ear a cavity at the opening of external ear canal to prevent the hematoma.The operation by operation recording system records filling time,postoperative again to weighing scales difference calculation stuffing cotton ball after period of time of blood loss,postoperative pain,patient evaluation and regularly followed up 12 months,assessment of 2 weeks,3 weeks and 4 weeks after the recovery of external auditory canal and tympanic membrane,and 6 months and 12 months after hearing recovery.Results 1 Surgical packing time: Compared with the gelatin sponge intervention group,the difference was statistically significant(P<0.05);2 Calculation of blood loss during the period of tamping: there was statistically significant difference in blood loss between the bleeding twill intervention group and the gelatin sponge intervention group(P<0.05);3Postoperative recovery of tympanic membrane and external auditory canal: the recovery of tympanic membrane and external auditory canal in the AFGF stanching satin intervention group was statistically different from that in the gelatin sponge intervention group at the2 nd and 3rd weeks after surgery(P<0.05),There was no significant difference in the recovery of tympanic membrane and external auditory canal between the AFGF stanching satin intervention group and the gelatin sponge intervention group at the 4th week after operation(P>0.05).4 There were significant differences in pure tone hearing threshold and air bone conduction difference between the two groups at 6 months and 12 months after operation(P<0.05).There were significant differences in pure tone hearing threshold and air bone conduction difference between the two groups at 6 months and 12 months after operation(P<0.05).There was no significant difference in the recovery of the two groups at 6 months after operation(P>0.05).There was no significant difference between the two groups(P>0.05).5 Pain after ear endoscopic tympanic membrane repair: there was no significant difference between the AFGF stanching satin intervention group and the gelatin sponge intervention group(P>0.05).Conclusions 1 The effect of AFGF stanching satin on tympanic membrane repair under endoscope:AFGF stanching satin can shorten the operative time of endoscopic tympanic membrane repair.2 AFGF stanching satin can significantly reduce the amount of blood loss during the period of tamping during the procedure of the operation.3 Influence of AFGF stanching satin on postoperative tympanic membrane repair: AFGF stanching satin can effectively promote the structural recovery of tympanic membrane and external auditory canal 2 and 3 weeks after surgery.There was no significant difference in the recovery of tympanic membrane and external auditory canal 4 weeks after operation.4 At6 months and 12 months after surgery,the hearing of the two groups was significantly improved compared with that before surgery: the pure tone hearing threshold was significantly increased,and the air bone gap was significantly reduced.There was no significant difference between the two groups in hearing at 6 months and 12 months after surgery.5 AFGF stanching satin did not significantly relieve the pain after endoscopic tympanic membrane repair.Figure22;Table11;Reference 151... |
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