地塞米松经鼓膜穿刺和经咽鼓管给药方案治疗慢性分泌性中耳炎临床疗效及安全性分析

Clinical efficacy and safety of dexamethasone through tympanic membrane puncture and eustachian tube in the treatment of chronic secretory otitis media

目的研究慢性分泌性中耳炎(SOM)使用地塞米松经鼓膜穿刺和经咽鼓管给药方案治疗的临床效果。方法 在本院选取120例SOM患者,选自2020年1月~2021年1月,使用随机数字表法分为两组,各60例,2组均给予地塞米松治疗,采取经鼓膜穿刺给药为B组,采取经咽鼓管给药为A组,2组治疗后临床效果对比。结果 A组较B组总有效率高,复发率、不良反应发生率均较低(P<0.05);2组治疗前2kHz、4kHz、8kHz骨导阈值水平与水通道蛋白1(AQP-1)、AQP-4对比无差异(P>0.05),治疗后A组较B组2kHz、4kHz、8kHz骨导阈值水平低,AQP-1、AQP-4指标均高(P<0.05)。结论经咽鼓管给予地塞米松,具有良好的临床效果,可改善患者各频率骨导阈值,促进 AQP水平上调,且可降低药物治疗不良反应发生率与复发率,值得借鉴。

Objective To study the clinical effect of dexamethasone in the treatment of chronic secretory otitis media (SOM).Method In our hospital,120 patients with SOM were selected from January 2020 to January 2021,and randomly divided into two groups,60 cases in each group.The two groups were given dexamethasone treatment,taking tympanic puncture as group B,taking eustachian tube as group A.The clinical effects of the two groups were compared after treatment.Result The total effective rate of group A was higher than that of group B,and the recurrence rate and adverse reactions rate were lower (P < 0.05);There was no difference between the two groups before treatment in the levels of bone conduction threshold of 2KHz,4kHz and 8kHz compared with AQP-1 and AQP-4 (P > 0.05).After treatment,the threshold level of bone conduction in group A was lower than that of group B (P < 0.05).Conclusion Dexamethasone given through eustachian tube has good clinical effect,can improve the bone conduction threshold of each frequency,promote the up regulation of AQP level,and can reduce the incidence of adverse reactions and recurrence rate of drug treatment,which is worthy of reference.