内淋巴囊减压术对梅尼埃病耳闷的疗效分析  

Efficacy of endolymphatic sac decompression on aural fullness in Ménière’s disease

作　　者：王辉兵[1] 李健[1] 孙勍[1] 陈元星 高云[1] 孙悍军[1] 王恩彤 单希征 Wang Huibing;Li Jian;Sun Qing;Chen Yuanxing;Gao Yun;Sun Hanjun;Wang Entong;Shan Xizheng(Department of Otolaryngology-Head and Neck Surgery,The Third Medical Center of Chinese PLA General Hospital,College of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,National Clinical Research Center for Otolaryngologic Diseases,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心耳鼻咽喉头颈外科解放军总医院耳鼻咽喉头颈外科医学部国家耳鼻咽喉疾病临床医学研究中心,北京100039

出　　处：《北京医学》2020年第9期813-816,共4页Beijing Medical Journal

基　　金：武警总医院科研课题(WZ2015029)。

摘　　要：目的探讨内淋巴囊减压术(endolymphatic sac decompression,ESD)对梅尼埃病耳闷的疗效。方法选取2015年1月至2017年10月解放军总医院第三医学中心81例伴有耳闷的梅尼埃病患者,比较ESD术前和术后耳闷评分的变化,术后耳闷变化与眩晕控制、听力变化、耳鸣变化的关系。耳闷严重程度采取视觉模拟评分(visual analogue score,VAS)进行分级:无耳闷(0分)、轻度(1~2分)、中度(3~4分)、中重度(5~6分)、重度(7~8分)、极重度(9~10分)。耳闷评分改善≥2分提示治疗有效。随访时间24~52个月,平均31个月。结果81例患者中,术前耳闷分级无耳闷、轻度、中度、中重度、重度、极重度的病例数分别为0、17、21、27、9、7,而术后分别为10、32、15、11、9、4,术前术后比较差异有统计学意义(U=3.765,P<0.01)。术后耳闷评分较术前下降≥4分,下降2~3分,不变(下降1分、0分、上升1分)、升高2~3分,升高≥4分的例数分别为15、33、23、6、4,ESD治疗耳闷的有效率为59.26%(48/81)。术后耳闷评分变化与眩晕控制程度(r=0.330,P<0.01)、听力变化(r=0.230,P<0.05)、耳鸣分级变化(r=0.259,P<0.05)有一定相关性。结论ESD对梅尼埃病耳闷有一定的缓解作用,并且术后耳闷评分变化与眩晕控制、听力变化、耳鸣变化呈轻度正相关,但术后仍有部分患者受到不同程度的耳闷困扰。Objective To investigate the efficacy of endolymphatic sac decompression(ESD)on aural fullness in intractable Ménière’s disease(MD).Methods A total of 81 patients with MD and with aural fullness hospitalized in the Third Medical Center of PLA General Hospital from January 2015 to October 2017 were selected.The changes of aural fullness scores before and after the operation were compared,and the relationship between the changes of aural fullness scores and vertigo control,hearing changes and tinnitus changes were compared.The severity of aural fullness was graded by visual analogue score(VAS),in cluding no aural fullness,mild,moderate,moderate to severe,severe,and extremely severe grade.Treatment was considered effective if the aural fullness score was reduced by at least two scores.The follow-up period ranged from 24 to 50 months,with an average of 31 months.Results The number of the cases with no aural fullness,mild,moderate,moderate to severe,severe,and extremely severe grade before operation were 0,17,21,27,9,7,while after operation,the number were 10,32,15,11,9,4,respectively.The scores of preoperative and postoperative aural fullness were compared(U=3.765,P<0.01).The number of the patients who’s aural fullness score decreased≥4,2-3,unchanged,increased 2-3,≥4 were15,33,23,6,4,respectively.The effective rate of ESD on aural fullness was 59.26%(48/81).There was a certain correlation between the postoperative score of aural fullness and vertigo control(r=0.330,P<0.01),hearing change(r=0.230,P<0.05),tinnitus grading change(r=0.259,P<0.05).Conclusions Endolymphatic sac decompression can alleviate the aural fullness of MD.The changes of postoperative aural fullness score are related to vertigo control,hearing changes and tinnitus changes,but some patients are still suffered from some degrees of aural fullness after surgery.

关 键 词：梅尼埃病 内淋巴囊减压术 耳闷 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]