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  

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

作　　者：梁冬泳[1] 何中扬[1] 李趣[1] 邹秀园[1] 黄岳[1] 王菊新[1] 卓勇智 

机构地区：[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

出　　处：《山东大学耳鼻喉眼学报》2015年第5期29-31,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2009008)

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。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 laryngo-scope,and the control group （n=33,36 ears）were treated with auripuncture and intratympanic dexamethasone injec-tion.These injections were repeated once every 2-3 days for 3 times.The clinical efficacy and complications were com-pared 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 in-jection have the same efficacy.Intratympanic dexamethasone through eustachian tube under electronic laryngoscope can be used as a new way for the treatment of OME.

关 键 词：电子鼻咽喉镜 分泌性中耳炎 咽鼓管 鼓室注药 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]