不同药物治疗急性化脓性中耳炎患者的临床疗效

Clinical efficacy of different drugs in the treatment of acute suppurative otitis media

目的:观察地塞米松联合左氧氟沙星滴耳对急性化脓性中耳炎患者中耳积液炎性因子及听力损伤指标的影响。方法:回顾性分析2021年1月—2022年12月诊治的急性化脓性中耳炎90例患者的临床资料,按治疗方案不同,分为观察组47例和对照组43例。对照组采用左氧氟沙星滴耳治疗,观察组采用地塞米松联合左氧氟沙星滴耳治疗。检测两组治疗前后中耳积液炎性因子[转化生长因子-β1(TGF-β1)、白细胞介素-2(IL-2)和肿瘤坏死因子-α(TNF-α)]水平,测定气导听力损失、骨导听力损失和1000 Hz听阀数值,记录退热时间、耳痛缓解时间和鼓膜充血消退时间,统计两组临床治疗总有效率,并记录不良反应发生情况。结果:治疗后两组中耳积液炎性因子(TGF-β1,IL-2和TNF-α)水平和听力损伤各指标(气导听力损失、骨导听力损失和1000 Hz听阀)数值均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组退热、耳痛缓解和鼓膜充血消退时间均少于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,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:地塞米松联合左氧氟沙星滴耳治疗急性化脓性中耳炎,可有效降低中耳积液炎性因子水平,改善听力阈值,缓解患者中耳炎症状,提高疗效,安全性良好。

Objective:To observe the effect of dexamethasone combined with levofloxacin on the inflammatory factors of middle ear effusion and hearing impairment indicators in patients with acute suppurative otitis media.Methods:The clinical data of 90 patients with acute suppurative otitis media treated in hospital from January 2021 to December 2022 were retrospectively analyzed,including 47 patients in the observation group and 43 patients in the control group.The control group was treated with levofloxacin ear drops,and the observation group was treated with dexamethasone combined with levofloxacin ear drops.The levels of inflammatory factors[transforming growth factor-β1(TGF-β1),interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)]in the middle ear effusion were measured before and after treatment in both groups.The air conduction hearing loss,bone conduction hearing loss and the value of 1000 Hz hearing valve were measured.The time of fever abating,the time of auricular pain relieving and the time of hyperemia subsiding were recorded,adverse reactions were recorded.Results:The levels of TGF-β1,IL-2 and TNF-αand hearing impairment(air loss,bone loss and 1000 Hz hearing valve)were significantly lower after treatment,and the inflammatory and hearing impairment values in the observation group were significantly better than those in the control group(P<0.05).In the observation group,the duration of antipyretic symptoms,ear pain relief and tympanic membrane congestion were significantly less than those in the control group(P<0.05).The total response rate in the observation group was significantly higher than the control group(P<0.05).The incidence of adverse effects between the two groups was not significant(P>0.05).Conclusion:The treatment of dexamethasone combined with levofloxacin in acute suppurative otitis media can effectively reduce the inflammatory factor level of middle ear fluid,improve the hearing threshold,relieve the symptoms of otitis media in patients,improve the efficacy,and have good safety.