经咽鼓管鼓室注入地塞米松联合地氯雷他定口服治疗分泌性中耳炎的疗效评估

Efficacy evaluation of intratympanic administration with dexamethasone through eustachian tube combined with desloratadine in treatment of secretory otitis media

目的观察经咽鼓管鼓室注入地塞米松联合地氯雷他定口服治疗分泌性中耳炎的效果及对咽鼓管功能的影响。方法 76例分泌性中耳炎患者,随机分为观察组和对照组各38例。对照组经咽鼓管鼓室注入地塞米松,观察组经咽鼓管鼓室注入地塞米松联合地氯雷他定口服。比较两组治疗效果及治疗后咽鼓管功能。结果治疗后1周、1个月,观察组疗效均显著优于对照组,差异有统计学意义(P<0.05)。治疗后随访3个月检测咽鼓管功能。治疗前,两组咽鼓管功能不良率比较,差异无统计学意义(P>0.05),治疗后,两组咽鼓管功能不良率均明显低于治疗前,差异有统计学意义(P<0.05);观察组咽鼓管功能不良率低于对照组,差异有统计学意义(P<0.05);观察组咽鼓管功能恢复率显著高于对照组,差异有统计学意义(P<0.05)。结论经咽鼓管鼓室注入地塞米松联合地氯雷他定口服治疗分泌性中耳炎,可减少渗出,改善咽鼓管功能,促进听力恢复。

Objective To observe the efficacy of intratympanic administration with dexamethasone through eustachian tube combined with desloratadine in treatment of secretory otitis media and its effect on function of eustachian tube. Method Seventy-six patients with secretory otitis media were randomly divided into observation group and control group. The control group received intratympanic administration with dexamethasone through eustachian. The observation group received intratympanic administration with dexamethasone through eustachian and oral administration of desloratadine. The therapeutic efficacy and the function of eustachian tube were compared between the two groups. Result The efficacy of the observation group was superior to that of the control group at one week and one month after treatment （ P 〈 0.05 ）. Three-month follow-up was performed after treatment for detection of the function of eustachian tube. Before treatment, there was no significant difference in the rate of eustachian tube dysfunction between the two groups （P 〈 0.05 ）. The rates of eustachian tube dysfunction in both groups after treatment were significantly lower than those before treatment （ P 〈 0.05）. After treatment, the rates of eustachian tube dysfunction in the observation group was lower than that in the control group （ P 〈 0.05 ）. The recovery rate of the eustachian tube functional in the observation group was significantly higher than that in the control group （ P 〈 0.05 ） . Conclusion For the treatment of secretory otitis media, intratympanic administration with dexamethasone through eustachian tube combined with desloratadine can decrease exudation, improve the function of eustachian tube and promote the recovery of hearing.