地塞米松磷酸钠联合咽鼓管球囊扩张术治疗难治性分泌性中耳炎临床价值研究  

Value of dexamethasone sodium phosphate combined with eustachian tube balloon dilation in the treatment of refractory secretory otitis media

作　　者：陈祖鸿 蔡章 黄冬冬 CHEN Zuhong;CAI Zhang;HUANG Dongdong(Department of Otolaryngology Head and Neck Surgery,the First Hospital of Putian City,Putian 351100,China)

机构地区：[1]莆田市第一医院耳鼻咽喉头颈外科,福建莆田351100

出　　处：《陕西医学杂志》2025年第2期234-238,243,共6页Shaanxi Medical Journal

基　　金：福建省卫生健康科研人才培养项目(2019-2-32)。

摘　　要：目的:探讨地塞米松磷酸钠联合咽鼓管球囊扩张术治疗难治性分泌性中耳炎的临床价值。方法:选取难治性分泌性中耳炎患者66例,并随机分为对照组和研究组,各33例。研究组给予地塞米松磷酸钠联合咽鼓管球囊扩张术治疗;对照组给予咽鼓管球囊扩张术治疗。比较两组治疗后临床疗效及并发症发生情况。于治疗前后,采用咽鼓管功能障碍问卷-7(ETDQ-7)评分对咽鼓管功能障碍进行评估;采用纯音测听检测气骨导差值及纯音听阈值;采用纯音听阈测试及声导抗测听检测静态声顺值及平均听阈值;检测白细胞介素-8(IL-8)、IL-5、肿瘤坏死因子-α(TNF-α)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)比值。结果:研究组治疗后总有效率高于对照组(P<0.05)。与对照组比较,研究组治疗后第3天ETDQ-7评分、气骨导差值、纯音听阈值、听力水平、血清IL-8、IL-5、TNF-α及CD8^(+)水平降低,静态声顺值、血清CD4^(+)水平、CD4^(+)/CD8^(+)比值升高(均P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论:地塞米松磷酸钠联合咽鼓管球囊扩张术治疗难治性分泌性中耳炎可改善患者听力,降低炎症反应,提高免疫功能,从而增强治疗疗效,且安全性较好。Objective:To explore the clinical value of dexamethasone sodium phosphate combined with eustachian tube balloon dilation in the treatment of refractory secretory otitis media.Methods:A total of 66 patients with refractory secretory otitis media were selected and randomly divided into a control group and a study group,with 33 cases in each group.The control group received eustachian tube balloon dilation treatment,while the study group received dexamethasone sodium phosphate combined with eustachian tube balloon dilation treatment.The clinical efficacy and incidence of complications after treatment in the two groups were compared.Before and after treatment,the ETDQ-7 score was used to assess eustachian tube dysfunction;pure tone audiometry was used to detect air-bone gap and pure tone threshold;pure tone threshold test and acoustic immittance were used to detect static acoustic compliance and average hearing thresholds;the levels of interleukin-8(IL-8),IL-5,tumor necrosis factor-alpha(TNF-α),CD4^(+),CD8^(+)and the CD4^(+)/CD8^(+)ratio were detected.Results:The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).Compared with the control group,the study group had lower ETDQ-7 scores,air-bone gap,pure tone thresholds,hearing levels,serum IL-8,IL-5,TNF-αand CD8^(+)levels,and higher static acoustic compliance,serum CD4^(+)levels,and CD4^(+)/CD8^(+)ratios on the third day after treatment(all P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:The combination of dexamethasone sodium phosphate and eustachian tube balloon dilation can improve hearing,reduce inflammatory responses,enhance immune function,thereby increasing the therapeutic efficacy for refractory secretory otitis media,and has good safety.

关 键 词：难治性分泌性中耳炎 地塞米松磷酸钠 咽鼓管球囊扩张术 炎性反应 免疫功能 安全性 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]