Balloon dilation of Eustachian tube combined with tympanostomy tube insertion and middle ear pressure equalization therapy for recurrent secretory otitis media

Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods: Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia, followed by long term middle ear pressure equalization therapies. The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre- and postoperative (up to 12 months) evaluation of Eustachian tube functions. Results: The mean ETS score was 2.34 ± 0.97 preoperatively, and 6.17 ± 1.54, 7.23 ± 1.62, 8.24 ± 1.97, and 7.63 ± 1.86 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). The ETDQ-7 score was 4.82 ± 1.07 preoperatively, and 2.20 ± 0.54, 2.32 ± 0.68, 2.53 ± 0.79, and 2.67 ± 0.76 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). Conclusion: Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media, as indicated by the ETS and ETDQ-7 scores, demonstrating high levels of efficacy and patient satisfaction.

Evaluation of the Clinical Efficacy of Qingqiao Capsule (清窍胶囊) in Treating Patients with Secretory Otitis Media

Objective： To observe the clinical efficacy of Qingqiao Capsule （清窍胶囊, QQC） in treating patients with secretory otitis media （SOM）. Methods： A total of 90 patients were randomly assigned into the treated group （n：45） and the control group （n=45）. Patients in the treated group were administrated with QQC, 5 capsules each time, 3 times a day for totally 10-14 days, and those in the control group were given per os cefaclor capsules 0.5g each time for adult, 3 times a day, or 20mg/（kg·d） for children, for 10-14 days. The therapeutic efficacy of treatment on the patients was observed and compared after treatment and followed up for 3-6 months. Results： （1） The clinical efficacy in the treated group was superior to that in the control group with significant statistical difference （P〈0.01）; （2） Comparison of the efficacies in patients of three different TCM syndrome types （the external pathogenic wind invasion caused auditory orifice stuffiness type, the Gan-Dan damp-heat steaming up auditory orifice type and the Pi-deficiency dysfunction induced dirty dampness blocking ear type） showed no statistically significant difference（P〉0.05）; （3） The vanishing rate and time needed of the main symptoms and signs in the treated group were superior to those in the control group on ear muffle, tinnitus, hearing impairment, hydrotypanum, pure tone threshold and abnormal tongue figure, and the difference was statistically significant （P〈0.05 or P〈0.01）, only those of earache, otopiesis and abnornal pulse figure were insignificantly different between the two groups （P〉0.05）. Conclusion： QQC is an effective Chinese composite medicine on patients with SOM, and shows no obvious adverse reaction.

Clinical Evaluation of Hearing Loss and Tinnitus in Secretory Otitis Media

Background: Secretory otitis media (SOM) patients usually complain about tinnitus accompanied with a sensation of hearing loss and ear fullness. Investigation of the association between Sensorineural hearing loss (SNHL) and tinnitus has been rarely reported. Methods: The clinical records of 34 patients with unilateral SOM accompanied with tinnitus were reviewed in search of bone conduct (BC) hearing thresholds and Tinnitus Handicap Inventory (THI). All the enrolled patients take audio-gram and THI preoperative and three month’s postoperative between February 2015 and January 2016. Differences between the affected side and the other in BC threshold, preoperatively and postoperatively were calculated. Correlations between BC thresholds’ lose and change of the THI scores’ postoperative data were analyzed. Results: The mean BC thresholds of the SOM ears preoperative were 18.3 ± 10.7 dBHL, which was higher than the other ear (16.6 ± 8.8 dBHL, t = 2.105, p t = 3.510, p t = 6.958, p t = 3.195, p t = 3.057, p Conclusion: SOM could bring about SNHL and tinnitus which reduced post-operatively. In addition, Tinnitus has correlation with bone-conduct hearing thresholds and conductive hearing loss.

鼻内镜下腺样体切除术对SOM患儿并发症的影响

目的探讨鼻内镜下腺样体切除术在分泌性中耳炎(SOM)患儿中的应用效果。方法选择2019年1月至2022年5月收治的SOM患儿94例,根据随机数表法将其分为参考组和观察组,每组47例。参考组采用鼓膜置管术治疗,观察组予以鼻内镜下腺样体切除术联合鼓膜置管术治疗治疗。观察2组听力水平[听性脑干反应(ABR)阀值、ABRI波潜伏期]、疗效、炎性反应[C-反应蛋白(CRR)、肺瘤坏死因子α(TNF-α)]、复发及并发症发生情况。结果2组术后12个月ABR阈值和ABR I波潜伏期水平均较本组术前低,差异有统计学意义(P<0.05),但2组间比较差异无统计学意义(P>0.05);观察组总有效率稍高于参考组,但2组差异无统计学意义(P>0.05);2组术后3 d的血清CRP、TNF-α水平均低于本组术前,且观察组较参考组低,差异有统计学意义(P<0.05);观察组术后12个月的病情复发率及术后12个月内的并发症发生率均明显较参考组低,差异有统计学意义(P<0.05)。结论鼻内镜下腺样体切除术联合鼓膜置管术治疗SOM患儿的疗效确切,能够减轻SOM患儿炎性反应,并可减少病情复发及并发症发生率。

THE EFFECT OF EXOGENOUS SURFACTANT ON THE EUSTACHIAN TUBE FUNCTION IN THE GERBIL MODEL OF SECRETORY OTITIS MEDIA

Objective To investigate the effect of exogenous surfactant on Eustachian tube opening function. Methods This reasarch measures for the Eustachian tube opening pressure by injection of surface active substance into middle ear space, studying the effect of surfactant on Eustachian tube opening function. Results It has been showed that the injection of killed streptococcus pneumoneac bacteria by the transtympanic route, successfully developed a secretory otitis media model. Eustachian tube opening pressure in ears with SOM was significantly greater than those without effusion ( P <0.01). Irrigation the middle ear space with surfactant resulted in a dramatic decrease in eustachian tube passive opening pressure in both normal and patients ( P <0.01). Conclusion The results indicate that flushing with exogenous surfactant by the transtympanic rote reduce of eustachian tube surface tension, and it benefits the Eustachian tube opening.

Changes of proinflammatory, fluid balance, vascular permeability and oxidative stress in patients with secretory otitis media

Objective: To investigate the changes of proinflammatory, fluid balance, vascular permeability and oxidative stress in patients with secretory otitis media. Methods: A total of 42 patients with secretory otitis media treated in our hospital from September 2016 to January 2018 were selected as the observation group and 42 healthy people as the control group. The levels of proinflammatory effect [including transforming growth factor beta 1 (TGF-β1), transforming growth factor-beta 2 (TGF-β2)], fluid balance [including aquaporin-1 (AQP-1) and aquaporin-4 (AQP-4)], vascular permeability [including hyaluronic acid (HA), fibronectin (Fn) and platelet activating factor (PAF)] and oxidative stress-related indexes [including malondialdehyde (MDA) and superoxide dismutase (SOD)] were observed and compared between the two groups. Results: The levels of AQP-1, AQP-4 and Fn in the observation group were significantly lower than those in the control group. The expression levels were (4.52±0.39) g/L, (23.06±7.21) g/L and (120.59±13.07) mg/L, respectively. The levels of TGF-β1, TGF-β2, HA, PAF, MDA and SOD were significantly higher than those of the control group and the expression levels were (11.99±4.23) 毺g/L, (4.22±1.66) 毺g/L, (70.54±6.99) 毺g/L, (123.83±20.58) ng/mL, (6.30±0.44) nmol/mL and (15.85±0.78) NU/mL, respectively. The difference was statistically significant. Conclusions: Inflammatory reaction occurs in patients with otitis media with secretory otitis media. It is easy to break the liquid balance in the middle ear cavity and to increase vascular permeability and oxidative stress. The relevant indicators should be strengthened in clinical practice, so as to provide evidence for early diagnosis and treatment of the disease.

Inflammatory factors, cellular immunity and humoral immunity in patients with secretory otitis media

Objective:To investigate the changes of inflammatory factors, cellular immunity and humoral immunity in patients with secretory otitis media.Methods:A total of 82 cases of secretory otitis media admitted in our hospital from January 2017 to December 2017 were selected as the observation group, and 80 healthy volunteers in our hospital were selected as the control group. The tumor necrosis factor-α (TNF-α), calcitonin (PCT), platelet activating factor (PAF), endothelin-1 (ET-1), CD3+, CD4+, CD8+, CD4+/CD8+, IgA, IgG, IgM. were detected and compared.Results: The levels of TNF-α, PCT, PAF and ET-1 in the observation group were (2.21 ± 0.13) ng/mL, (3.96 ± 0.81) ng/mL, (149.50 ± 21.08) ng/mL, and (1.67 ± 0.53) μg/L, which were all higher than those of the control group, the differences were significant. The levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were (51.95 ± 4.47)%, (37.04 ± 3.94)% and (1.10 ± 0.04) respectively, which were all lower than those in the control group, the differences were significant. The level of CD8+ in the observation group was (33.63 ± 3.94)%, higher than that in the control group, the difference was significant. The levels of IgA, IgG and IgM in the observation group were (4.97 ± 0.22) g/L, (31.16 ± 2.53) g/L and (5.12 ± 0.17) g/L respectively, which were all higher than the control group, the differences were significant.Conclusion:Inflammatory factors and immune status of patients with secretory otitis media are abnormal. It is suggested to strengthen clinical monitoring of relevant indicators.

耳聋左慈丸治疗慢性分泌性中耳炎临床疗效及作用机制研究

目的 观察耳聋左慈丸联合西医疗法治疗慢性分泌性中耳炎的临床疗效,并分析其作用机制。方法 选择2022年1月—2022年12月于医院耳鼻喉科治疗的200例慢性分泌性中耳炎患者,采用随机数字表法将上述患者分为对照组和试验组,每组100例,对照组患者予以西医常规治疗,试验组在对照组基础上予以耳聋左慈丸治疗。比较两组患者的临床疗效、症状和不良反应情况,以及治疗前后听力水平、耳积液炎症因子水平变化。结果 对照组患者的有效率为(80.00%,80/100),试验组患者的有效率为(90.00%,90/100),与对照组比较,试验组的有效率明显升高(P<0.05)。治疗前、治疗后1周两组患者的ETDQ-7无明显差异(P>0.05);治疗后3周后,试验组患者的ETDQ-7水平相较于对照组均明显下降(P<0.01)。干预完成后,试验组患者耳鸣、耳闷、听力下降以及鼓室积液等主要症状评分水平相较于对照组均明显降低(P<0.01)。干预完成后,与对照组患者比较,试验组患者0.5、1、2 kHz的纯音听阈明显降低,差异具有统计学意义(P<0.01)。干预前两组患者的耳积液炎症因子水平差异无统计学意义(P>0.05);干预完成后,试验组患者耳积液中IL-1β、IL-8以及TNF-α水平相较于对照组均明显下降(P<0.01)。干预过程中所有患者的主要不良反应有恶心呕吐、食欲不振、腹痛腹泻、头晕头痛等,两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论 耳聋左慈丸联合西医疗法治疗慢性分泌性中耳炎具有良好的临床效果,提高患者听力水平,改善临床症状,抑制局部炎症反应,且无不良反应增加。

奥美拉唑在分泌性中耳炎合并咽喉反流患者中的治疗价值

目的:探讨奥美拉唑在分泌性中耳炎(SOM)合并咽喉反流(LPR)患者中的治疗价值。方法:选取单侧或双侧SOM合并LPR患者82例,根据治疗方案不同将患者分为治疗组(35例)和对照组(47例)。所有患者均给予鼓膜穿刺术、配合使用鼻部激素、口服黏液促排剂和抗组胺药物1个月。治疗组同时给予患者抗反流宣教及足疗程奥美拉唑抗反流干预。随访3个月,比较两组患者治疗前后气骨导差、七项咽鼓管功能障碍症状评分量表(ETDQ-7)评分及临床疗效。结果:两组治疗后第1~3个月气骨导差较治疗前降低(均P<0.05)。治疗组治疗后第1~3个月气骨导差低于对照组(均P<0.05)。两组患者治疗后第1~3个月ETDQ-7评分较治疗前降低(均P<0.05)。治疗组治疗后第1~3个月ETDQ-7评分较对照组降低(均P<0.05)。治疗后第2、3个月,治疗组总有效率高于对照组(均P<0.05)。结论:对于SOM合并LPR患者,奥美拉唑能改善咽鼓管功能,提高听力水平及SOM治疗效果。

分泌性中耳炎中耳积液成分研究进展

分泌性中耳炎(SOM)是指以传导性聋及鼓室积液为主要特征的不伴有急性炎性表现的中耳积液的非化脓性中耳炎。其病因与生理机制复杂,以耳闷、耳鸣、耳痛等耳部症状为主,各年龄段均可发生,而学龄前儿童是高发人群。目前,SOM病因及发病机制尚未完全阐明,对SOM中耳积液的成分分析是研究SOM病因及发病机制的常见方法,也是指导临床治疗的重要途径,本文通过查阅国内外发表的相关文献,对SOM中耳积液的成分研究进展进行比较总结,以提高临床医师对该病的认识。

SOM模型大鼠中耳黏膜及耳积液中TNF-α的表达及抗TNF-α治疗的机制研究

目的探讨抗TNF-α单克隆抗体对大鼠分泌性中耳炎(SOM)的治疗作用及其机制。方法应用随机数字表法将90只健康成年SD大鼠分成三组:对照组、SOM组、抗TNF-α治疗组,每组又根据SOM制成后不同时点,再分为6 h、1 d、3 d、7 d和14 d组,每组6只动物。HE染色后观察中耳黏膜上皮组织病理变化,应用免疫组织化学法检测中耳黏膜上皮组织中TNF-α的表达情况,并采用酶联免疫吸附(ELISA法)检测大鼠耳积液(MEE)中TNF-α的表达水平。结果制模后各时相,对照组标本中无TNF-α的阳性表达,而SOM组和抗TNF-α治疗组中耳黏膜上皮细胞中TNF-α表达灰度值均呈逐渐升高趋势,且较对照组均显著增强(P<0.05)。制模后各时相SOM组和抗TNF-α治疗组之间比较,除6 h组外,抗TNF-α治疗组其余3个时相中耳黏膜上皮细胞中TNF-α表达灰度值均明显低于SOM组(P<0.05)。制模后各时相SOM组MEE中TNF-α的表达水平均高于对照组,呈逐步上升趋势,差异均有显著性(P<0.05)。制模后各时相抗TNF-α治疗组MEE中TNF-α蛋白含量的变化曲线与SOM组相似。两组间不同时间点比较,抗TNF-α治疗组MEE中TNF-α蛋白含量明显均低于SOM组(P<0.05)。结论抗TNF-α治疗通过拮抗TNF-α的炎症介导作用而抑制中耳炎症及免疫反应,有助于减轻急性期炎症反应和阻止慢性SOM的发生。

中药汤剂治疗分泌性中耳炎的网状meta分析

目的 运用基于贝叶斯框架的网状meta分析法评价中药汤剂治疗分泌性中耳炎的临床效果。方法 检索Pub Med、Web of Science、Embase、The Cochrane Library、中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库建库至2023年7月中关于中药汤剂治疗分泌性中耳炎的研究,采用Cochrane偏倚风险评估工具进行质量评价,使用Stata 17.0和Ge MTC 0.14.3软件进行数据分析。结果 最终纳入19项研究,样本量为2 069例,涉及9种中药汤剂。网状meta分析结果显示,常规西药分别联合使用加味清震汤(OR=0.27,95%CI:0.07~0.73)、参苓白术散(OR=0.29,95%CI:0.11~0.74)、耳胀汤(OR=0.17,95%CI:0.08~0.35)、二陈汤(OR=0.29,95%CI:0.11~0.69)、健脾通窍方(OR=0.32,95%CI:0.12~0.78)、荆防败毒散(OR=0.17,95%CI:0.08~0.35)、龙胆泻肝汤(OR=0.23,95%CI:0.11~0.48)、疏风宣肺通窍汤(OR=0.21,95%CI:0.08~0.60)、宣肺通窍汤(OR=0.15,95%CI:0.04~0.41)的临床总有效率均高于单用常规西医治疗。等级概率图结果显示,宣肺通窍汤效果最优。结论中药汤剂治疗分泌性中耳炎可提高总有效率,其中宣肺通窍汤效果最优,但仍需更大样本、更高质量的临床随机对照研究以进一步验证。

糠酸莫米松喷鼻联合鼓膜切开术治疗儿童分泌性中耳炎的疗效观察

目的探讨糠酸莫米松喷鼻联合鼓膜切开术治疗儿童分泌性中耳炎的疗效。方法选取2018年5月至2022年6月于我院就诊的100例腺样体肥大、分泌性中耳炎患儿,按照随机数字表法分为观察组与对照组各50例。两组均行腺样体切除术+鼓膜切开术,观察组再予糠酸莫米松喷雾剂治疗。比较两组治疗前后纯音听阈、生活质量[疾病特异性生活质量调查量表(OSA-18)]及炎性因子[白介素-6(IL-6)、白介素-2(IL-2)及C反应蛋白(CRP)]水平,观察两组临床疗效、声导抗鼓室图、并发症发生率。结果观察组治疗后总有效率(92.00%)高于对照组的76.00%(P<0.05);治疗后两组纯音听阈、OSA-18评分均较治疗前降低,观察组OSA-18评分较对照组低(P<0.05);治疗后两组纯音听阈、声导抗鼓室图比较,差异无统计学意义(P>0.05),两组IL-6、IL-2、CRP水平均较治疗前降低,且观察组低于对照组(P<0.05);观察组总并发症发生率(10.00%)低于对照组的28.00%(P<0.05)。结论糠酸莫米松喷鼻联合鼓膜切开术治疗儿童分泌性中耳炎疗效确切,可显著提高听力及生活质量,抑制炎症反应,并发症较少。

化痰通窍汤联合桉柠蒎肠溶软胶囊治疗分泌性中耳炎的临床疗效

目的观察化痰通窍汤联合桉柠蒎肠溶软胶囊治疗分泌性中耳炎的临床疗效。方法选取2022年3月—2023年3月福建中医药大学附属宁德市中医院收治的分泌性中耳炎患者60例,按随机数字表法分为常规西药组和中西联合组,各30例。常规西药组给予常规西药治疗,中西联合组在常规西药组基础上联合化痰通窍汤+桉柠蒎肠溶胶囊治疗,2组均持续治疗2周。比较2组临床疗效,用药前及用药2周后不同频率下听阈值、临床症状评分,症状及体征改善时间,不良反应。结果中西联合组总有效率高于常规西药组(93.33%vs.70.00%,χ^(2)=5.455,P=0.020)。用药2周后,2组500、1000、2000 Hz下听阈值低于用药前,且中西联合组低于常规西药组(P<0.01);2组耳鸣、耳闷塞、听力障碍评分低于用药前,且中西联合组低于常规西药组(P<0.01)。中西联合组中耳积液、耳闷塞、耳鸣消失时间与听力恢复时间短于常规西药组(P<0.05或P<0.01)。中西联合组不良反应总发生率低于常规西药组(6.67%vs.26.67%,χ^(2)=4.320,P=0.038)。结论化痰通窍汤联合桉柠蒎肠溶胶囊治疗分泌性中耳炎的疗效显著,可快速改善患者的临床症状及体征,提高听力水平,促进病情转归,且具有较高的安全性。

小儿分泌性中耳炎耳积液中CD44和TLR4表达与腺样体肥大的相关性

目的检测小儿分泌性中耳炎患儿耳积液中分化簇44(CD44)和Toll样受体4(TLR4)表达水平,并分析二者与腺样体肥大的相关性。方法选取纳入80例小儿分泌性中耳炎患儿为观察组,选取同期接受健康体检的100例健康儿童为对照组。检测观察组患儿及对照组儿童耳积液中CD44和TLR4表达水平,并分析二者与腺样体肥大的相关性。采用Pearson法分析耳积液中CD44与TLR4表达水平的相关性。采用受试者工作特征(ROC)曲线分析CD44、TLR4对腺样体肥大的诊断价值。结果CD44、TLR4在观察组患儿外周血、耳积液中的表达水平相较于对照组儿童外周血中的表达水平显著升高(P<0.05);CD44、TLR4在观察组患儿耳积液中的表达水平相较于观察组患儿外周血中的表达水平显著升高(P<0.05);CD44、TLR4在观察组浆液性耳积液中的表达水平相较于黏液性耳积液中的表达水平显著降低(P<0.05);CD44、TLR4在观察组慢性中耳炎患儿耳积液中的表达水平相较于急性中耳炎耳积液中的表达水平显著降低(P<0.05);CD44、TLR4在腺样体肥大中耳炎患儿耳积液中的表达水平相较于腺样体正常中耳炎耳积液中的表达水平显著升高(P<0.05);小儿分泌性中耳炎耳积液中CD44和TLR4表达呈正相关(r=0.516,P=0.000)。CD44、TLR4二者联合诊断腺样体肥大的诊断价值显著高于二者单独诊断。结论CD44、TLR4均在小儿分泌性中耳炎耳积液中的表达水平上调,且相较于腺样体正常的患儿,腺样体肥大的患儿耳积液中CD44、TLR4表达水平显著升高,与腺样体肥大密切相关。

腺样体手术患儿分泌性中耳炎的临床特征及疗效分析

目的 探究腺样体肥大手术患儿分泌性中耳炎临床特征及不同手术的治疗效果。方法 选取2019年12月—2022年12月常州市儿童医院耳鼻喉科收治的2210例腺样体肥大手术患儿,依据临床资料(术中诊断)将患儿分为分泌性中耳炎组233例和无分泌性中耳炎组1977例,比较其临床特征;分泌性中耳炎组根据术式分为鼓膜切开组211例和鼓室置管组22例,比较治愈率。结果 腺样体手术患儿分泌性中耳炎组不同性别、不同腺样体与鼻咽腔比值发病率与无分泌性中耳炎组比较,差异均无统计学意义(P>0.05),分泌性中耳炎组不同年龄发病率与无分泌性中耳炎组比较,差异有统计学意义(P<0.01);分泌性中耳炎患儿鼓膜切开组治愈率与鼓室置管组比较,差异无统计学意义(P>0.05)。结论 分泌性中耳炎术前诊断需要结合声导抗、电测听、耳内镜综合判断;年龄影响腺样体肥大患儿分泌性中耳炎的发病率;在充分处理咽鼓管咽口阻塞的情况下,鼓膜切开治疗与鼓室置管治疗疗效相当。

孟鲁司特联合盐酸氨溴索对分泌性中耳炎的治疗效果

目的 探究孟鲁司特联合盐酸氨溴索对分泌性中耳炎(SOM)患者的临床疗效。方法 收集2021年2月至2023年7月联勤保障部队第九八八医院收治的102例SOM患者作为研究对象,对其病例资料进行回顾性分析,根据治疗方案不同将患者分为对照组(盐酸氨溴索治疗)和联合组(孟鲁司特联合盐酸氨溴索治疗),各51例。比较2组临床疗效、治疗前后鼓室压、纯音气导听阈值、血清相关因子[超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、高迁移率族蛋白B1(HMGB1)、降钙素原(PCT)]水平和复发率。结果 联合组临床总有效率为98.04%,显著高于对照组的84.31%(P<0.05);治疗后,联合组鼓室压、纯音气导听阈值、血清hs-CRP、IL-8、HMGB1及PCT水平均显著低于对照组(P<0.001);联合组复发率2.04%,显著低于对照组的16.33%(P=0.036)。结论 孟鲁司特联合盐酸氨溴索治疗SOM疗效显著,可改善患者听力水平,调节炎性因子水平,且复发率低。

赛洛唑啉滴鼻剂联合吸入用布地奈德混悬液治疗小儿分泌性中耳炎的临床效果

目的:了解赛洛唑啉滴鼻剂联合吸入用布地奈德混悬液治疗小儿分泌性中耳炎的临床效果及对可溶性白介素2受体(sIL-2R)、T淋巴细胞亚群水平的影响。方法:将毕节市第一人民医院2021年3月—2022年5月收治的95例分泌性中耳炎患儿随机分为试验组(47例)及对照组(48例)。对照组患儿应用鼓膜穿刺术、抗生素及吸入用布地奈德混悬液治疗,试验组在此基础上加用赛洛唑啉滴鼻剂,对比两组患儿的治疗效果、治疗前后的鼓室压和气导听阈、治疗前后sIL-2R和T淋巴细胞亚群水平及不良反应。结果:试验组患儿临床治疗有效率(91.49%)高于对照组(75.00%)(P<0.05)。治疗前,两组患儿鼓室压、气导听阈比较差异均无统计学意义(P>0.05);治疗后,两组患儿鼓室压、气导听阈均较治疗前改善(P<0.05),且试验组鼓室压、气导听阈均较对照组优,差异均有统计学意义(P<0.05)。治疗前,两组患儿sIL-2R、白细胞分化抗原(CD)3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)T淋巴细胞比较差异均无统计学意义(P>0.05);治疗后,两组患儿sIL-2R、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)T淋巴细胞均较治疗前低,CD8^(+)T淋巴细胞较治疗前增高(P<0.05),且试验组sIL-2R、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)T淋巴细胞水平均低于对照组,试验组CD8^(+)T淋巴细胞高于对照组(P<0.05)。两组患儿不良反应发生率差异无统计学意义(P>0.05)。结论:赛洛唑啉滴鼻剂联合吸入用布地奈德混悬液治疗小儿分泌性中耳炎的临床效果确切,且能通过影响sIL-2R、T淋巴细胞亚群从而调整机体免疫功能,副作用小。

咽鼓管球囊扩张术联合鼓膜置管术治疗慢性分泌性中耳炎疗效分析

目的:分析药物治疗和咽鼓管球囊扩张术联合鼓膜置管术治疗慢性分泌性中耳炎临床疗效。方法:选取2019年11月~2023年3月弋矶山医院60例慢性分泌性中耳炎患者进行分组,观察组30例接受咽鼓管球囊扩张术+鼓膜置管术,对照组30例采用药物治疗,记录两组患者的纯音听阈均值(PTA)、气骨导差(ABG)以及咽鼓管功能障碍7项评分问卷(ETDQ-7)评分。结果:观察组术后总体有效率(100.00%)高于对照组(70.00%)(P<0.01)。观察组患者治疗前、治疗后1个月及治疗后3个月的PTA、ABG、ETDQ-7评分均较对照组患者下降(P<0.05)。结论:咽鼓管球囊扩张术联合鼓膜置管术治疗慢性分泌性中耳炎安全有效,值得临床推广应用。