甲泼尼龙治疗小儿分泌性中耳炎34例临床观察

Methylprednisolone in treatment of 34 children with secretory tympanitis

目的:评价甲泼尼龙治疗小儿分泌性中耳炎的临床疗效和安全性。方法:66例(74耳)分泌性中耳炎的患儿分为2组。试验组34例(37耳),其中男性18例,女性16例,年龄(10±3)岁,应用甲泼尼龙8mg,po,qd×3d;3d后改为4mg,po,qd×3d;6d后改为2mg,po,qd×3d。对照组32例(37耳),男性15例,女性17例,年龄(9±4)岁,应用地塞米松0.25mg,po,tid×9d。观察2组治疗9d后和随访3月时的疗效和安全性。结果:治疗9d后在随访的3个月内进行随访,至少每15d随访1次,并作详细记录。2组气导平均听阈值和鼓室导抗图峰压值均下降,与治疗前比较差异有极显著性(P<0.01),其中试验组下降幅度大于对照组(P<0.01)。试验组有效率分别为97%和91%,对照组的有效率分别为84%和72%,2组疗效比较差异有显著性,试验组优于对照组(P<0.05)。试验组不良反应发生率9%,低于对照组的22%,但差异无显著性(P>0.05)。结论:甲泼尼龙治疗小儿分泌性中耳炎有效、安全。

OBJECtIVE To evaluate the clinical effect and safety of methylprednisolone in the treatment of children with secretory tympanitis（ST）. METHODS Sixty six children （74 ears） with ST were divided into two groups. Thirty-four children （M 18, F 16, age （10±3）a , 37 ears） in the trial group were treated with methylprednisolone 8 mg, po,qd× 3 d; 3 d later changed to 4 mg,po,qd × 3 d; 6 d later changed to 2 mg,po,qd × 3 d. Thirty-two children in the control group （M 15,F 17, age（9 ± 4）a , 37 ears） were treated with dexamethasone 0. 25 rag, po, tid × 9 d. The clinical efficacies and safeties were observed at the third month of follow up for all the two groups after the treatment. RESULTS At the third month of follow up, the hearing level and peak pressure value decreased with significant difference in comparing with those before the treatment （P 〈0.01） in both groups. The decreased level in the trial group was higher than in the control group（P〈0. 01 ）. According to the hearing, tinnitus and sense of block, the pressure value of peak point and the total clinical effective rates were 97 % and 91 % in the trial group, and the control group were 84 % and 72 %. The clinical efficacy of the trial group was superior to the control group （P〈0. 05）. The adverse reaction rates were 9 % in the trial group and 22 % in the control group （P〉0. 05）. CONCLUSION Methylprednisolone is a safe and effective drug in treating ST.