曲安奈德鼓室灌注治疗分泌性中耳炎的临床研究

目的 分泌性中耳炎主要由咽鼓管口的机械性阻塞和感染引起,常规采用鼓膜穿刺抽液加口服糖皮质激素进行治疗。本研究通过穿刺抽液并曲安奈德鼓室灌注治疗分泌性中耳炎,并与传统的抽液后口服糖皮质激素治疗的疗效进行比较,探寻出一种新的简便有效的治疗办法。 方法 将100例分泌性中耳炎分为实验组和对照组,实验组采用鼓膜穿刺抽液后曲安奈德鼓室灌注治疗;对照组采用鼓膜穿刺抽液后口服糖皮质激素;2组患者均口服抗生素(头孢克洛缓释片0.375 g,2次/d)及氨溴索颗粒(30 mg,3次/d)10 d,盐酸赛洛唑啉鼻用喷雾剂喷鼻1周(2次/d);治疗后2周、1个月时复查纯音测听及声导抗,并对结果进行分析比较;所有病例随访3~6个月,然后根据是否有治愈后复发再次对其复发率进行比较。 结果 疗程结束后1个月,实验组和对照组耳的治愈率分别为75.00%(45/60)和51.85% (28/54)。进行3~6个月随访,实验组和治疗组耳的复发率分别为6.67%(3/45)和25.00%(7/28),实验组的治愈率高于对照组,其疗效(治愈、有效、无效)差异有统计学意义(均P<0.05),实验组复发率低于对照组,差异无统计学意义(P>0.05)。2组病例均无并发症发生。 结论 曲安奈德鼓室灌注治疗分泌性中耳炎操作简便,疗效可靠,安全性高,值得临床推广。 

Clinical research of intratympanic triamcinolone acetonide for otitis media with effusion

Objective Oral corticosteroids are commonly used to administrate otitis media with effusion (OME), which majorly caused by mechanical obstruction and infection was routinely treated by tympanic membrane puncture with oral corticosteroids. In this study, triamcinolone acetonide infusion were employed to search for a more effective therapeutics. And the effects were compared with the aformentioned routine therapeutics. Methods A total of 100 cases of OME were randomly divided into experimental group and control group. After auripuncture, the experimental group received intratympanic injection of triamcinolone acetonide, while the control group received oral glucocorticoids treatment. All patients were administrated with Cefaclor Sustained Release Tablets, 0.375 g, b.i.d and ambroxol, 30 mg, t.i.d, for 10 days, and Xylometazoline Hydrochloride Nasal Spray (b.i.d) for 1 week. Pure tone test and acoustic immittance were performed in 2 weeks and 1 month later. All patients were followed up for 3 to 6 months to observe the recurrence rates. Results One month after the treatment, the cure rate in the experimental group and control group was 75.00% (45/60) and 51.85% (28/54); the follow-up showed that the recurrence rate was 6.67% (3/45) in the experimental group and 25.00% (7/28) in the control group. The cure rate was higher in the experimental group than in the control group, the difference in curative effect (cured, effective or not) between the two group was statistically significant (P<0.05). The recurrence rate decreased in the experimental group and the difference was not statistically significant (P>0.05). No complications occurred in both groups. Conclusion Intratympanic triamcinolone acetonide in the treatment of OME is easy to operate, with reliable curative effect and highly safe. It is worthy of clinical promotion.