鼓室注射庆大霉素治疗梅尼埃病25例疗效分析

Treatment of Meniere's disease with intratympanic injection of gentamicin

目的观察鼓室注射庆大霉素混合液治疗难治性梅尼埃病的临床疗效。方法对25例单侧梅尼埃病患者行患侧鼓室内注射庆大霉素混合液(40g/L的庆大霉素1ml,加0.6mol/L的碳酸氢钠缓冲液0.5ml,制成30g/L浓度的庆大霉素)每5d1次,共2次,随访2年以上。采用1996年上海会议制定的梅尼埃病诊断依据及疗效分级标准诊断及判定疗效。结果25例中,治疗后22例眩晕达到有效控制,其中3例患者经1次注射后眩晕就得到控制;14例患者2次注射后眩晕达到控制,有6例患者经3次注射后眩晕得到控制;另外2例注射了2次后因出现前庭中毒征兆而停药。结论鼓室注射庆大霉素的方法治疗梅尼埃病疗效显著,方法简单,操作方便,病人痛苦小,不良反应小,值得在基层医院进一步探讨和推广应用。

Objective To explore the efficacy of intratympanic injection with small dosage gentamicin in treatment of patients with intractable Meniere＇s disease. Methods Gentamicin was intratympanically given to 25 patients with Meniere＇s disease in unilateral ear, once every five days for two times. The typical dosage was 1 ml of gentamicin （ 30g/L, made by diluting 1 ml gentamicin in concentration of 40 g/L with 0.5ml of 0.6 mol/L sodium bicarbonate solution）. All patients were followed - up for at least two years, The results were monitored and evaluated with Diagnostic Criteria for Meniere＇s Disease set by Chinese Society of Otorhinolaryngology and Editorial Board of Chinese Journal of Otorhinlolaryngology in Shanghai Meeting in 1996. Results Among twenty - five patients with Meniere＇s disease treated by intratympanic injection of gentamicin, control of vertigo was achieved in 21 patients （88%）. Among them, vertigo was successfully alleviated ＂after single injection in 3 patients, second injection was needed in 14 patients and third injection was needed to control vertigo in 6 patients. Two patients had interrupted treatment after two injections because of symp- toms of ototoxicity. Conclusion Intratympanic injection of gentamicin is a simple, less side effect and cost - effective method for controlling intractable vertigo symptom in patients with Meniere＇s disease. It is worthy to be introduced for clinical application in community hospitals.