山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (5): 29-31.doi: 10.6040/j.issn.1673-3770.0.2015.144

• 论著 • 上一篇    下一篇

两种途径鼓室注入地塞米松治疗分泌性中耳炎的临床研究

梁冬泳, 何中扬, 李趣, 邹秀园, 黄岳, 王菊新, 卓勇智   

  1. 广西医科大学附属南宁市第一人民医院耳鼻咽喉头颈外科, 广西 南宁 530022
  • 收稿日期:2015-04-08 修回日期:2015-09-22 出版日期:2015-10-16 发布日期:2015-10-16
  • 通讯作者: 何中扬,E-mail:hzhongyang@126.com E-mail:hzhongyang@126.com
  • 作者简介:梁冬泳,E-mail:leonstar@163.com
  • 基金资助:
    广西壮族自治区卫生厅自筹经费科研课题(Z2009008)

Intratympanic injection of dexamethasone for otitis media with effusion by two different methods

LIANG Dongyong, HE Zhongyang, LI Qu, ZOU Xiuyuan, HUANG Yue, WANG Juxin, ZHUO Yongzhi   

  1. Department of Otolaryngology & Head and Neck Surgery, First People's Hospital Affiliated to Guangxi Medical University, Nanning 530022, Guangxi, China
  • Received:2015-04-08 Revised:2015-09-22 Online:2015-10-16 Published:2015-10-16

PDF (PC)

859

被引次数

10

摘要： 目的 探讨两种途径进行鼓室注入地塞米松治疗分泌性中耳炎的有效性和安全性,方式分别为电子鼻咽喉镜下咽鼓管注药、鼓膜穿刺鼓室注药。方法 将药物治疗1周~1个月但疗效欠佳的分泌性中耳炎患者65例(69耳),分成两组进行治疗,治疗组32例(33耳)行电子鼻咽喉镜下咽鼓管注药治疗,对照组33例(36耳)行鼓膜穿刺鼓室注药治疗,每2~3 d注药1次, 共治疗3次。随访10~12个月,比较两组患者的疗效以及并发症的发生情况。结果 疗程结束后3个月,治疗组和对照组总有效率分别为93.9%(31/33)和83.3%(30/36)。随访10~12个月,治疗组和对照组复发率分别为15.2%(5/33)和33.3%(12/36),治疗组总有效率高于对照组,复发率低于对照组,但差异均无统计学意义(P>0.05),两组病例未见并发症发生。结论 电子鼻咽喉镜下经咽鼓管注药和鼓膜穿刺注药两种方法鼓室注入地塞米松治疗分泌性中耳炎有相同疗效,电子鼻咽喉镜下咽鼓管注药疗法可作为分泌性中耳炎治疗的新途径。

关键词: 电子鼻咽喉镜, 分泌性中耳炎, 鼓室注药, 咽鼓管

Abstract: Objective To evaluate the efficacy and safety of intratympanic injection of dexamethasone to treat otitis media with effusion (OME) by two different methods, namely, through Eustachian tube under electronic laryngoscope, and auripuncture and intratympanic injection. Methods A total of 65 OME cases (69 ears) with poor curative effect after conventional medical therapy for 1-4 weeks were randomly divided into two groups. The treatment group (n=32, 33 ears) were treated with intratympanic dexamethasone injection through eustachian tube under electronic laryngoscope, and the control group (n=33, 36 ears) were treated with auripuncture and intratympanic dexamethasone injection. These injections were repeated once every 2-3 days for 3 times. The clinical efficacy and complications were compared between the two group after a followed-up of 10~12 months. Results The total effective rate in the treatment group and control group was 93.9% (31/33) and 83.3% (30/36), respectively, and the recurrence rate was 15.2% (5/33) and 33.3% (12/36). The total effective rate was higher in the treatment group than in the control group while the recurrence rate was lower in the treatment group. But the differences had no statistical significance (both P>0.05). No complications occurred in both groups. Conclusion Two methods about intratympanic dexamethasone injection have the same efficacy. Intratympanic dexamethasone through eustachian tube under electronic laryngoscope can be used as a new way for the treatment of OME.

Key words: Eustachian tube, Otitis media with effusion, Intratympanic injection, Electronic laryngoscope

中图分类号: 

  • R764.2
[1] 王刚, 吴长松, 刘成, 等. 桉柠蒎肠溶软胶囊联合鼓膜置管治疗慢性分泌性中耳炎[J]. 山东大学耳鼻喉眼学报, 2013, 27(2):16-17. WANG Gang, WU Changsong, LIU Cheng, et al. ELP enteric soft capsule and grommet insertion for chronic secretory otitis media [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(2):16-17.
[2] 段卫红,万世恒, 陈静华, 等. 鼻内镜下咽鼓管置管术治疗分泌性中耳炎[J]. 中国耳鼻咽喉头颈外科, 2006, 13(10):703-705. DUAN Weihong, WAN Shiheng, CHEN Jinghua, et al. Eustachian tube insertion under endoscope for secretory otitis media[J]. Chin Arch Otolaryngol Head Neck Surg, 2006, 13(10):703-705.
[3] Mustafa P, Gokhan A, Mehmet E, et al. Effectiveness of intratympanic dexamethasone in otitis media with effusion resistant to conventional therapy[J]. Otolaryngol Head Neck Surg, 2013, 65(3):461-467.
[4] Cutler J L, Wall M, Labadie R F. Effects of ototopic steroid and NSAIDS in clearing middle ear effusion in an animal model[J]. Otolaryngol Head Neck Surg, 2006, 135(4):585-589.
[5] Yaman H, Ozturk K, Uyar Y, et al. Effectiveness of corticosteroids in otitis media with effusion: an experimental study[J]. Laryngol Otol, 2008, 122(1):25-30.
[6] 李明. 鼻内镜下鼓膜穿刺治疗分泌性中耳炎80例疗效观察[J]. 中国耳鼻咽喉颅底外科杂志, 2013, 9(2):156-157. LI Ming. Tympanic membrane puncture under endoscope in the treatment of secretory otitis media in 80 cases[J]. Chin J Otorhinolaryngol Skull Base Surgery, 2013, 9(2):156-157.
[7] Wallace I F, Berkman N D, Lohr K N, et al. Surgical treatments for otitis media with effusion: a systematic review[J]. Pediatrics, 2014, 133(2):296-311.
[8] 韩开亮, 孔娟, 宋忠云, 等. 鼻内镜下咽鼓管扩张导管治疗慢性分泌性中耳炎13例分析[J]. 山东大学耳鼻喉眼学报, 2013, 27(5):19-21. HAN Kailiang, KONG Juan, SONG Zhongyun, et al. Endoscopic eustachian tube dilated catheter for chronic secretory otitis media in 13 cases[J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(5):19-21.
[1] 倪凌达,唐旭兰,孟丽丽,周慧群,苏开明. 电子鼻咽喉镜中I-scan各模式与白光模式的应用比较[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 19-25.
[2] 王登茂,温鑫,耿江桥,张光远,刘晓峰. 儿童咽鼓管毛息肉合并鼻咽部错构瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 105-109.
[3] 周莹,王刚,王磊,张晓丽,韩浩伦,李保卫,孙喆喆,吴玮. 咽喉反流相关中耳炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 131-135.
[4] 林云仙,马玲国. 咽鼓管圆枕淀粉样变性伴中耳积液1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 86-90.
[5] 樊永将,黄卫,何成山,沈海涛,徐正,郝亚楠. SARS-CoV-2感染后成人急性分泌性中耳炎细胞因子水平分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 1-6.
[6] 伊同英,王雪妮,韩旭东,白彩颖,吴岐珍. 吸入麻醉在儿童电子鼻咽喉镜检查中的应用效果及安全性评价[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 26-29.
[7] 孙艳,姚浩,顾黎安. 布地奈德联合盐酸氨溴索鼓室内注射治疗成人分泌性中耳炎的疗效研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 77-82.
[8] 高信忠, 林宗通, 沈翎, 刘平凡, 林兴, 许杨杨. 咽鼓管球囊扩张联合腺样体切除术治疗儿童分泌性中耳炎疗效分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 7-12.
[9] 焦雪梅,杨扬,李春凤,张晓琳. 鼓膜置管对分泌性中耳炎患儿咽鼓管功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 60-63.
[10] 吴华,孙永明,郑建华,蔡雪花. 腺样体消融联合鼓膜打孔术治疗儿童腺样体肥大合并分泌性中耳炎55例[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 71-75.
[11] 林宗通,沈翎,杨中婕. 腺样体大小及圆枕类型对儿童分泌性中耳炎的影响[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 121-126.
[12] 曹鑫,伊海金,李欣,许嘉,高娟娟. 分泌性中耳炎合并突发性聋三例并文献复习[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 56-61.
[13] 倪菁,雷飞,白丹,周韵,马建梅,黄伟,王春阳. 儿童分泌性中耳炎耳积液中免疫相关指标表达分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 56-59.
[14] 张浩亮,于锋,吴云文. 咽鼓管功能障碍的慢性化脓性中耳炎治疗分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 72-75.
[15] 杨钦泰. 重视儿童“侧呼吸道”过敏性炎症[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 59-62.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发