耳内镜下鼓膜穿刺治疗鼻咽癌放疗后分泌性中耳炎效果观察

Curative Effect of Auripuncture Under Otic Endoscope on Secretory Otitis Media after Nasopharyngeal Carcinoma Radiotherapy

目的观察耳内镜下鼓膜穿刺治疗鼻咽癌放疗后分泌性中耳炎的效果。方法选取2014年6月—2017年12月于我院治疗的76例鼻咽癌放疗后分泌性中耳炎患者,按照治疗方法的不同分为鼓膜穿刺组39例和药物治疗组37例,鼓膜穿刺组采用耳内镜下鼓膜穿刺治疗,药物治疗组给予单纯药物治疗。比较两组治疗前及治疗后血清炎症指标[白细胞介素8(IL-8)、转化生长因子β1(TGF-β1)]水平,听力改善情况,治疗效果及治疗期间不良反应发生情况。结果治疗后,两组血清IL-8、TGF-β1水平均下降,且鼓膜穿刺组血清IL-8、TGF-β1水平均低于药物治疗组,差异均有统计学意义(P<0.01)。治疗后气导听阈改善幅度、气骨导差改善幅度均大于药物治疗组(P<0.01)。鼓膜穿刺组总有效率为94.87%高于药物治疗组的75.68%,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论耳内镜下鼓膜穿刺治疗鼻咽癌放疗后分泌性中耳炎效果较好,可有效抑制机体炎性反应,促进听力恢复,且不良反应较少。

Objective To observe curative effect of auripuncture under otic endoscope on secretory otitis media after nasopharyngeal carcinoma radiotherapy.Methods A total of 76 patients with secretory otitis media after nasopharyngeal carcinoma radiotherapy who were treated in our hospital from June 2014 to December 2017 were enrolled.According to different treatment methods,they were divided into auripuncture group(n=39)and drug treatment group(n=37).The auripuncture group was treated with auripuncture under otic endoscope,while drug treatment group was given drug therapy alone.The levels of serum inflammatory indexes[interleukin-8(IL-8),transforming growth factor-β1(TGF-β1)],hearing improvement and curative effect before and after treatment,and occurrence of adverse reactions during treatment were compared between the two groups.Results After treatment,levels of serum IL-8 and TGF-β1 in both groups were decreased(P<0.01).And the above indexes in auripuncture group were lower than those in drug treatment group(P<0.01).After treatment,improvement of air conduction hearing threshold and air-bone conduction in auripuncture group was greater than that in drug treatment group(P<0.01).The total response rate in auripuncture group was higher than that in drug treatment group(94.87%vs 75.68%)(P<0.05).There was no significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of auripuncture under otic endoscope is good on secretory otitis media after nasopharyngeal carcinoma radiotherapy,which can effectively inhibit body inflammatory response,and promote hearing recovery,with fewer adverse reactions.