耳内镜下联合盐酸左氧氟沙星滴耳液对儿童分泌性中耳炎听力恢复及炎性因子的影响  

Influence of Endotoscope Combined with Levofloxacin on Listening Recovery and Inflammation Factors of Children with Secretory Otitis Media

作　　者：赵阳[1] 孔磊[1] 

机构地区：[1]徐州市中心医院耳鼻喉科,江苏徐州221009

出　　处：《医学综述》2016年第24期4962-4964,4968,共4页Medical Recapitulate

摘　　要：目的 研究耳内镜下联合盐酸左氧氟沙星滴耳液对儿童分泌性中耳炎（SOM）听力恢复及炎性因子的影响。方法 选取2013年4月至2015年3月徐州市中心医院收治的SOM患儿44例,按抽签法分为观察组和对照组,各22例。对照组采取耳内镜下鼓膜置管手术,观察组在此基础上联合盐酸左氧氟沙星滴耳液,每次5~10滴,每日3次,所有患儿均以2周为1个疗程。比较两组患儿的临床症状改善情况、听力恢复状况、炎性因子水平、临床疗效、复发率及并发症。结果 治疗后,观察组患儿的0.5、1、2 k Hz纯音听阈气导听力水平显著高于对照组[（21.3±3.2）d B比（11.3±1.4）d B、（17.3±2.5）d B比（10.2±1.1）d B、（13.4±1.8）d B比（7.3±0.8）d B],差异有统计学意义（P〈0.01）。观察组的白细胞介素2（IL-2）、IL-6、免疫球蛋白E、肿瘤坏死因子α水平显著低于对照组[（9.4±2.4）ng/L比（15.2±2.4）ng/L、（18.4±3.2）ng/L比（26.3±2.5）ng/L、（154±16）μg/L比（192±19）μg/L、（0.25±0.06）μg/L比（0.46±0.07）μg/L],差异有统计学意义（P〈0.01）。观察组患儿总有效率显著高于对照组[90.9%（20/22）比63.6%（14/22）],差异有统计学意义（P〈0.05）。两组患儿复发率及脱管率、堵管率比较差异无统计学意义（P〉0.05）。观察组耳漏率低于对照组[31.8%（7/22）比4.5%（1/22）],差异有统计学意义（P〈0.05）。结论 耳内镜下联合盐酸左氧氟沙星滴耳液有利于提高SOM患儿听力水平,改善炎性因子水平和临床症状,是安全有效的治疗方式。Objective To study influence of endotoscope combined with levofloxacin on the listening recovery and inflammation factors of children with secretory otitis media （ SOM ）. Methods Total of 44 children with SOM in Xuzhou Central Hospital from Apr. 2013 to Mar. 2015 were included in the study, according to the sortition method, all of the children were divided into an observation group and a control group ,22 cases in each group. The control group received endotoscope assisted tympanostomy tube insertion, and the observation group was given levofloxacin on the basis of the control group＇s treatment,5-10 drops each time ,3 times/d, all of them were treated 2 weeks as a course. The clinical symptoms improvement, hearing recovery situation, level of inflammatory factors, clinical curative effect and recurrence rate and complication of the two groups were compared. Results After treatment,the 0. 5,1,2 kHz pure tone hearing threshold air conduction heating level of the observation group were significantly higher than the control group[ （21.3 ± 3.2） dBvs （11.3±1.4） dB,（17.3± 2.5） dB vs （10.2± 1.1） dB,（13.4±1.8） dB vs （7.3±0. 8） dB ], the differences were statistically significant （ P 〈 0. 01 ）. The interleukin-2 （ IL-2 ）, IL-6, irmnunoglobulin-E （IgE）, tumor necrosis factor （TNF）α inflammatory factor levels of the observation group were significantly lower than the control group [ （ 9.4 ±2. 4 ） ng/L vs （ 15.2± 2. 4 ） ng/L, （ 18.4 ± 3.2 ） ng/L vs （26.3 ±2.5） ng/L,（154±16） μg/L vs （192 ±19） μg/L,（0. 25 ±0.06） μg/L vs （0.46 ±0.07）μg/L] （P 〈 0. 01 ）. The total effective rate of the observation group was significantly higher than the control group [ 90. 9% （20/22 ） vs 63.6% （ 14/22 ） ] （ P 〈 0.05 ）. There was no significant difference between the two groups in the relapse rate, the rate of detachment and the rate of occlusion （ P 〉 0.05 ）. The otorrhea rate in the observation group was lower than that in

关 键 词：分泌性中耳炎 耳内镜 左氧氟沙星 听力 炎性因子 

分 类 号：R744.21[医药卫生—神经病学与精神病学]