鼻咽癌放疗和鼓室注射曲安奈德对中耳压力的相关性分析  

The analysis of the correlation of tympanic injection of triamcinolone acetonide and middle ear pressure after radiotherapy

作　　者：谢华[1] 孙文忠[1] 秦卫红[1] 阙颖[1] 戴善军[1] 郑青平[2] 

机构地区：[1]广西柳州市人民医院耳鼻咽喉科,广西柳州545006 [2]广西柳州市人民医院肿瘤放疗科

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第22期1785-1788,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2011年柳州市科技局应用技术研究与开发计划课题(No:2011J0302027)

摘　　要：目的：分析鼓室注射曲安奈德与鼻咽癌放疗后中耳压力（MEP）及并发放射性分泌性中耳炎（RSOM）的相关性。方法：将52例放疗前无中耳炎的鼻咽癌患者随机分为3组。治疗一组17例（34耳）,放疗开始前1h每侧鼓室注射曲安奈德注射液,第1~7周每周1次;治疗二组17例（34耳）,放疗开始前1h每侧鼓室注射曲安奈德注射液,第1~12周每周1次;对照组18例（36耳）,不行鼓室注射。放疗开始及开始后第1、2、3个月末测104耳的MEP。结果：放疗开始时至开始后1、2、3个月末治疗一组、二组及对照组RSOM罹患率逐渐增高,MEP逐渐减小,其中治疗二组RSOM罹患率最低,MEP最大（P〈0.01）;治疗一组RSOM罹患率较低,MEP较大（P〈0.05）;对照组RSOM罹患率最高,MEP最小（P〉0.05）。结论：鼓室注射曲安奈德可减轻中耳放射性损伤,用药时间与MEP呈正相关,与RSOM罹患率呈负相关,且疗程越长疗效越显著;放疗后3个月末RSOM、MEP变化趋势最明显,可能与放疗后3个月始中耳放射损伤较修复更为活跃有关,长期疗效仍须继续观察。Objective：To analyze the correlation of the tympanic injection of triamcinolone acetonide,middle ear pressure（MEP）and radioactive secretory otitis media（RSOM）with nasopharyngeal carcinoma（NPC）after radiotherapy.Method：Fifty-two patients suffering NPC without otitis media before radiotherapy were randomly divided into three groups.17 cases with 34 ears were distributed into treatment groupⅠ,and radiotherapy 1hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection,1~7weeks 1times a week.Treatment groupⅡ had 17cases with 34 ears,and radiotherapy 1hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection,1~12weeks 1times a week.And control group consisted of 18 cases with 36 ears who didn′t accept such treatment.In all 104 ears,MEP was tested at the begin of radiotherapy and the end of 1st,2nd,3rd month after radiotherapy.Result：From the beginning of radiotherapy to the end of th 1st,2nd,3rd month after radiotherapy,the morbidity of RSOM gradually increased and MEP decreased in the treatmentgroupⅠ,Ⅱand the control group,in which treatment groupⅡ showed the lowest morbidity of RSOM and MEP was maximum（P〈0.01）,and the treatment groupⅠ showed the lower morbidity of RSOM and MEP was greater（P〈 0.05）,while the control group showed the highest morbidity of RSOM and MEP was minimum（P〉0.05）.Conclusion：Tympanic injection of triamcinolone acetonide could reduce radiation injury,and medication time was positively correlated with the MEP,and a negative correlation with RSOM morbidity,and the longer treatment,the more significant the effect is.The difference is most obvious at the end of 3rd month after radiotherapy.It may be due to the more active repairation after radiation damage in middle ears,but long-term efficacy must continue to observe.

关 键 词：曲安奈德 鼓室注射 鼻咽肿瘤 放疗 中耳压力 

分 类 号：R739.6[医药卫生—肿瘤]