成年人分泌性中耳炎行鼓膜置管术并鼓室注射地塞米松的疗效分析

Efficacy of tympanic membrane catheterization and intratympanic dexamethasone injection for adult secretory otitis media

目的探讨鼓膜置管术联合鼓室注射地塞米松治疗成年人分泌性中耳炎(OME)的效果。方法选取我院成年人OME患者106例,随机数字表法分为2组,各53例。对照组予鼓膜置管术,研究组在对照组基础上鼓室注射地塞米松。比较2组疗效、并发症,以及治疗前、治疗2周、治疗4周后鼓室图情况、气导与骨导听阈、血清降钙素原(procalcitonin,PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素8(IL-8)、CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平。结果研究组总有效率高于对照组,并发症发生率低于对照组(P<0.05);治疗2周、治疗4周后,研究组鼓室图情况、气导与骨导听阈优于对照组,血清PCT、TNF-α、IL-8、CD8^(+)水平低于对照组,CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05)。结论鼓膜置管术联合鼓室注射地塞米松治疗成年人OME具有良好效果。

OBJECTIVE To investigate the effect of tympanic membrane catheterization combined with intratympanic injection of dexamethasone in the treatment of adult secretory otitis media(OME).METHODS 106 adult OME patients selected from our hospital were randomly divided into two groups,53 cases in each group.The control group was given tympanic membrane catheterization,and the study group was injected dexamethasone into tympanic cavity on the basis of the control group.The curative effect,complications,tympanogram,air conduction and bone conduction hearing threshold,serum procalcitonin(PCT)and tumor necrosis factor-α(TNF-α),Interleukin-8(IL-8),CD8^(+),CD4^(+),CD4^(+)/CD8^(+)levels were compared between the two groups.RESULTS The total effective rate of the study group was higher than that of the control group,and the incidence of complications was lower than that of the control group(P<0.05);After 2 and 4 weeks of treatment,tympanogram,air conduction and bone conduction hearing thresholds of the study group were better than those of the control group,serum PCT and TNF-αlevels of the study group were higher than those of the control group,the levels of IL-8 and CD8^(+)were lower than those of the control group,and the levels of CD4^(+),CD4^(+)/CD8^(+)were higher than those of the control group(P<0.05).CONCLUSION Tympanic membrane catheterization combined with intratympanic dexamethasone injection is effective in the treatment of adult OME.