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地塞米松不同给药方式治疗慢性分泌性中耳炎的疗效和安全性比较
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| 篇名： | 地塞米松不同给药方式治疗慢性分泌性中耳炎的疗效和安全性比较 |
| TITLE： | |
| 摘要： | 目的：比较地塞米松不同给药方式治疗慢性分泌性中耳炎的疗效和安全性。方法：150例慢性分泌性中耳炎患者随机分为对照组（75例）和观察组（75例）。对照组患者于内镜下经鼓膜穿刺给予地塞米松磷酸钠注射液5 mg。观察组患者于内镜下经咽鼓管给予地塞米松磷酸钠注射液5 mg。两组均每2 d 1次，共治疗3次。观察两组患者的临床疗效，治疗前后1、2、4、8 kHz 频率骨导阈值、水通道蛋白1、水通道蛋白4水平，复发情况和鼓室积液发生情况，并记录不良反应发生情况。结果：观察组患者总有效率（93.33％）显著高于对照组（80.00％），复发率、鼓室积液发生率均显著低于对照组，差异均有统计学意义（P＜0.05）。治疗前，两组患者各频率骨导阈值、水通道蛋白1、水通道蛋白4水平比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者各频率骨导阈值水平均显著低于同组治疗前，且观察组显著低于对照组；两组患者水通道蛋白1、水通道蛋白4水平均显著高于同组治疗前，且观察组显著高于对照组，差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：内镜下经咽鼓管给予地塞米松治疗慢性分泌性中耳炎在疗效、减轻临床症状、改善各频率骨导阈值、上调水通道蛋白表达水平、降低复发和鼓室积液风险方面均显著优于经鼓膜穿刺给药，但两种给药方式的安全性相当。 |
| ABSTRACT： | OBJECTIVE： To compare therapeutic efficacy and safety of dexamethasone with different administration routes in the treatment of chronic secretory otitis media. METHODS： A total of 150 patients with chronic secretory otitis media were randomly divided into control group （75 cases） and observation group （75 cases）. Control group was given Dexamethasone sodium phosphate injection 5 mg by auripuncture under endoscope. Observation group was given Dexamethasone sodium phosphate injection 5 mg via eustachian tube under endoscope. Both groups were given relevant medicine every 2 days， for 3 times in total. Clinical efficacies of 2 groups were observed as well as bone conduction threshold under 1， 2， 4， 8 kHz， the levels of water channel protein 1 and water channel protein 4， recurrence， the occurrence of tympanic cavity effusion before and after treatment. The occurrence of ADR was recorded. RESULTS： The total response rate of observation group （93.33％） was significantly higher than that of control group（80.00％）； recurrence rate and the incidence of tympanic cavity effusion of observation group were significantly lower than those of control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in bone conduction threshold， the levels of water channel protein 1 and water channel protein 4 between 2 groups （P＞0.05）. After treatment， the levels of bone conduction threshold in 2 groups were significantly lower than before； the observation group was significantly lower than the control group. The levels of water channel protein 1 and water channel protein 4 in 2 groups were significantly higher than before； the observation group was significantly higher than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS： The administration of dexamethasone via eustachian tube under endoscope is significantly better than auripuncture in terms of therapeutic efficacy for chronic secretory otitis media， relieving clinical symptom， improving bone conduction threshold， up-regulating water channel protein level， reducing the risk of recurrence and tympanic cavity effusion. The two routes of adimistration have similar safety. |
| 期刊： | 2017年第28卷第21期 |
| 作者： | 杨琛，尹中普 |
| AUTHORS： | YANG Chen，YIN Zhongpu |
| 关键字： | 鼓膜穿刺；咽鼓管；地塞米松；慢性分泌性中耳炎；疗效；安全性 |
| KEYWORDS： | Auripuncture； Eustachian tube； Dexamethasone； Chronic secretory otitis media； Therapeutic efficacy； Safety |
| 阅读数： | 543 次 |
| 本月下载数： | 2 次 |
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