分泌性中耳炎采用糖皮质激素治疗的效果评价  

Using glucocorticoids effect evaluation for the treatment of secre tory otitis media

作　　者：王桂芳[1] 郝园园[1] 王庭良[1] 黄观辉[1] 陈宝叔 胡明清[1] 

机构地区：[1]解放军第59医院耳鼻咽喉科,云南开远661600

出　　处：《中国中西医结合耳鼻咽喉科杂志》2017年第2期88-90,98,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探究分泌性中耳炎采用糖皮质激素治疗的临床效果及评价。方法选取我院2013年3月-2016年6月经听力检查、鼓气耳镜检查和鼓膜穿刺确诊的分泌性中耳炎患者96例为研究对象,按就诊顺序数字随机分成常规组和糖皮质组,每组48例,分别采用常规治疗方法和联合应用地塞米松药物治疗,比较两组患者的治疗效果。结果两组治疗后复发率统计糖皮质组4.17%低于常规组22.92%,且具有差异统计学意义(P<0.01)。两组治疗后进行气导听阈测试3项指标,糖皮质组均优于常规组,且具有差异统计学意义(P<0.01)。2组治疗后的鼓膜形态改善状况(79.17%vs52.08%)和治疗有效率(95.83%vs77.08%),糖皮质组均高于常规组,均具有差异统计学意义(P<0.01)。治疗后糖皮质组中耳积液中血小板活化因子(PAF)、白介素6(IL-6)和血清炎症因子的水平值均低于常规组(P<0.05)。两组治疗过程中未见不良反应。结论采用糖皮质激素治疗分泌性中耳炎,可降低复发率、提高患者听力水平、减轻炎症反应、疗效显著是理想用药。Objective To explore the treatment of secretory otitis media using glucocorticoid effects and evaluation. Methods Selection of our hospital （from March 2013 to June 2016）hearing examination, otoscopy and tympanic membrane puncture cheerily confirmed 96 cases of patients with secretory otitis media as the research object, according to the doctor order Numbers randomly divided into normal group and glucocorticoid group, each group of 48 cases, useing conventional treatment methods and the combined use of dexamethasone therapy, the therapeutic effect of 2 groups were compared. Results Two groups after treatment recurrence rate statistics of glucocorticoid group 4.17% lower than normal group 4.17%, and has a statistically significant difference （P〈 0.01）. Two groups after treatment for air conduction audibility threshold test 3 indicators, glucocorticoid group were better than the conventional group, with statistical significance difference （P〈0.01）. Two groups after treatment of tympanic membrane morphology to improving vs52.08%（79.17%） and the treatment efficient vs77.08 %（95.83%）, glucocorticoid group were higher than in normal group, has statistically significant difference （P〈0.01）. The levels of PAT and IL-6 in serum and MEF in glucocorticoid group were significantly lower than those in onventional group （P〈0.05）. No abverse reactions in two group treatment process. Conclusion Usingglucocorticoid in the treatment of secretory otitis media, can reduce the recurrence rate and improve patients＇ listening level,reduce inflammation reaction, curative effect is distinct is an ideal drug use.

关 键 词：分泌性中耳炎 糖皮质激素 听力测试 中耳积液 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]