鼓室注射曲安奈德减轻鼻咽癌放疗后听力损失的效果

目的 评价鼓室注射曲安奈德减轻鼻咽癌放疗后听力损失的临床疗效。方法 选择2011年3月~2012年9月在柳州市人民医院确诊为鼻咽癌并接受放射治疗的90例患者,随机分为3组。治疗一组29例58耳,放疗始至第7周每周每侧鼓室注射曲安奈德1次;治疗二组29例58耳,放疗始至第12周每周每侧鼓室注射曲安奈德1次;对照组32例64耳,不采取任何措施。比较90例患者放疗始及放疗后第7、12周末气导听阈均值、声导抗、耳内镜结果。结果 三组放疗始及第7、12周末气导听阈均值、异常声导抗耳数、鼓室积液率均逐渐增大。放疗后第7周末,治疗一组、治疗二组气导听阈均值、异常声导抗发生率、鼓室积液率、中耳炎发生率均相近,且明显低于对照组,差异均有统计学意义(P<0.05);放疗后第12周末,治疗一组、治疗二组的气导听阈均值、异常声导抗耳数发生率、鼓室积液率、中耳炎发生率均明显低于对照组,差异均有统计学意义(P<0.05),并且上述各指标治疗一组均高于治疗二组,差异有统计学意义(P<0.05)。三组均未见严重药物不良反应。结论 所有患者放疗后3个月时气导听阈均增高,鼓室注射曲安奈德可减轻鼻咽癌放疗后听力损失的程度,有效保护听力。

Clinical effect of tympanic cavity injection with Triamcinolone acetonide in treating hearing loss of patients with nasopharyngeal carcinoma receiv-ing radiotherapy

Objective To evaluate the clinical effect of tympanic cavity injection with Triamcinolone Acetonide in treat-ing the hearing loss of patients with nasopharyngeal carcinoma receiving radiotherapy. Methods From March 2011 to September 2012, in the People＆#39;s Hospital of Liuzhou City, 90 patients diagnosed nasopharyngeal carcinoma and given the radiotherapy in the period were randomly divided into three groups. 29 cases with 58 ears were in tretment group 1 and given injecting Triamcinolone acetonide every week from the beginning of radiotherapy to the 7th week, 29 cases with 58 ears were in treatment group 2 and given injecting Triamcinolone acetonide every week from the beginning of radiotherapy to the 12th week, 32 cases with 58 ears were in the control group and not given tympanic cavity injection of Triamcinolone Acetonide. 90 patients accepted the examinations of pure tone test, acoustic immitance test, endoto-scope at beginning of radiotherapy, the 7th and 12th week and the resuts were corpared. Results According the results of examinations executed at beginning of radiotherapy, at the 7th and 12th week, the value of the average audibility threshold of air conduction, the occurrence rate of abnormal acoustic immitance and the rate of tympanic cavity effusion and the occur rate of secretory otitis media were increased gradually. At the end of the 7th week, the value of the ex-aminations were closed of two treatment groups, and lower than that of the control group, the differences were statisti-cally significant （P〈0.05）. At the end of the 12th week, the value of the examinatios in two tretment groups were lower than that in the control group, the differences were statistically significant （P〈 0.05）, and all the value above in tret-ment group 1 were higher than those in tretment group 2, the differences were statistically significant （P〈 0.05）. There was no serious drug adverse reaction. Conclusion All of the patients＆#39; air-conduction audibility threshold increases, and the tympanic c