鼓气球鼓室充气治疗梅尼埃病疗效观察  

The Intratympanic Inflation by Tympanum Inflatable Balloon for Meniere's Disease

作　　者：张运波[1] 习国平[1] 王彩君[1] 赵秀云[1] 梁佳[1] 王毅[1] 

机构地区：[1]河北省邯郸市第三医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2015年第5期481-484,共4页Journal of Audiology and Speech Pathology

摘　　要：目的：探讨经鼓膜置管鼓气球鼓室充气治疗梅尼埃病的疗效。方法将36例确诊为Ⅱ－Ⅲ期（按0．25、0．5、1、2、3 kHz平均听阈分期：Ⅱ期平均听阈25～40 dB HL ，Ⅲ期平均听阈41～70 dB HL）梅尼埃病发作期患者随机分为鼓气组和对照组，每组18例；对照组Ⅱ期6例，Ⅲ期12例，在耳内镜下行鼓膜置管后，鼓室灌注甲泼尼龙0．5ml，每3天灌注一次，共三次；鼓气组Ⅱ期5例，Ⅲ期13例，在耳内镜下行鼓膜置管后，应用鼓气球鼓室充气治疗，每次鼓气6～8次，每天4次，至病情缓解；两组均同时给予常规改善微循环、营养神经治疗，两组均保留置管2年，发作期重复上述治疗；随访18～24个月，观察患者眩晕、活动能力、听力及耳鸣变化。结果鼓气组6例眩晕完全控制（A级），10例眩晕基本控制（B级），2例眩晕部分控制（C级），眩晕有效控制率为88．89％（16／18）；对照组3例眩晕完全控制（A级），7例眩晕基本控制（B级），8例眩晕部分控制（C级），眩晕有效控制率为55．56％（10／18），鼓气组眩晕有效控制率高于对照组（χ2＝4．985，P＜0．05）。两组患者耳鸣及纯音平均听阈治疗后与治疗前比较差异无统计学意义（P＞0．05）。两组治疗后活动能力均明显改善，差异无统计学意义（P＞0．05）。结论应用鼓膜置管后鼓气球鼓室充气治疗Ⅱ、Ⅲ期梅尼埃病患者，其眩晕有效控制率高，活动能力明显改善，但耳鸣及听力改善不明显。Objective To evaluate the clinical efficacy of the intratympanic inflation by tympanum inflatable balloon for patients with Meniere’s disease（MD） .Methods A total of 36 confirmed cases （according to the listening stage） of Ⅱ - Ⅲ period of MD patients were randomly divided into two groups ：experimental group and control group ,18 cases of matched group ,who were staged before preoperation by hearing ,Ⅱ period （average threshold 25~40 dB HL） 6 cases ,Ⅲ period （41~70 dB HL） 12 cases ,were treated by intratympanic methylprednisolone per‐fusion after putting tympanostomy tube under endotoscope ,then once every 3 days perfusion with a total of three times .There were 18 cases of experimental group staged before preoperation by hearing ,Ⅱ period （average thresh‐old 25~40 dB HL） in 5 cases ,Ⅲ period （41~70 dB HL） 13 cases treated by using tympanum inflatable balloon in the tympanum under endotoscope .Two groups were given conventional improved microcirculation and nutritional therapy .Results In 18 cases of patients in experimental group ,for the 18 to 24 months follow -up after treatment ,6 cases of vertigo were fully controlled （grade A） ,10 cases of vertigo basically controlled （grade B） ,2 cases of vertigo partly controlled （grade C） .Vertigo effective control rate was 88 .89% （16/18） .After 18 to 24 months treatment ,two groups of 36 patients with tinnitus and pure tone average threshold had no obvious change .In 18 ca‐ses of patients in the matched group ,during the 18 to 24 months follow -up after treatment ,3 cases of vertigo were fully controlled （grade A） ,7 cases of vertigo basically controlled （grade B） ,8 cases of vertigo partly controlled （grade C） .Vertigo effective control rate was 55 .56% （10/18） .The experimental vertigo basic control rates were higher than the control group （χ2 = 4 .985 ,P〈0 .05） .The activitives in the two groups had improved significantly . No obvious differences were found between two groups .Conclu

关 键 词：梅尼埃病 眩晕 鼓膜置管 鼓室充气 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]