口服和鼓室内注射糖皮质激素治疗分泌性中耳炎的疗效观察  

The Therapeutic Effects of Oral Administration and Intratympanic Injection of Glucocorticoid in the Treatment of Otitis Media with Effusion

作　　者：周涵[1] 陈智斌[1] 王登元[1] 徐霞[1] 赵晓埝[1] 邢光前[1] 

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,南京210029

出　　处：《听力学及言语疾病杂志》2009年第6期560-562,共3页Journal of Audiology and Speech Pathology

摘　　要：目的探讨口服和鼓室内注射糖皮质激素治疗分泌性中耳炎(otitis media with effusion,OME)的疗效。方法选择84例病程在8周之内的OME患者(8～56岁)为研究对象,在进行鼓室穿刺抽液及口服抗生素的基础上,随机分成A组,30例34耳,予小剂量短疗程口服泼尼松治疗;B组,30例32耳,予地塞米松鼓室内注射2～4次;C组,24例26耳,口服抗生素,鼓室穿刺抽液。疗程结束后随访3个月。结果A、B两组分别有70.6%和53.1%的患耳在一周内有不同程度好转。治疗一个月后,A、B、C三组的总有效率分别为88.2%(30/34耳)、90.6%(29/32耳)和69.2%(18/26耳);A组与B组总有效率比较差异无统计学意义(P>0.05),但A、B两组与C组总有效率比较差异有统计学意义(P<0.05)。结论口服或鼓室内注射糖皮质激素均为治疗OME的有效方法。ObJective To investigate cocortieoid in the management of otitis media the efficacy of oral administration and intratympanic injection of gluwith effusion（OME）. Methods The study included 84 patients,ranging 8 to 56 years in age, with OME of no more than 2 months＂ duration. All patients received antibiotic treatment and tympanotomy with 3 months＇ follow-up. They were randomly assigned to three groups, namely, the treatment group A （30 patients 34 ears, oral administration of short-term and small dose of prednisone）, the treatment group B （30 patients az ears, 2～4 intratympanic injections of dexamethasone ） and control group（24 patients 26ears）. Results 70.6 % ears of treatment group A and 53.1 %ears of treatment group B showed complete or partial recow ery in one week＇s therapy. At the end of four weeks, improvement rates were 88.2% （30/34 ears） for treatment group A, 90.6% （29/32 ears） for treatment group B, and 69.2% （18/26 ears） in the control group, respectively. Significantly higher improvement rate was obtained in both treatment groups when compared with the control group （P〈0.05）, but no statistical difference existed between the two treatment groups＇ improvement rates（P〉0. 05）. Conclusion Both oral administration and intratympanic injection of glucocorticoid are effective for the treatment of OME. Oral administration of short-term and small dose of glucocorticoid is fast, effective and convenient. Intratympanic injection of glueocortieoid is especially favorable to patients who have contraindieations of steroids or those need long-term therapy. The efficacy of both treatments of OME with glucocorticoid in the longer term,howerer, needs further investigation.

关 键 词：糖皮质激素 分泌性中耳炎 鼓室内注射 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]