鼓室注射庆大霉素与地塞米松治疗难治性梅尼埃病的疗效分析

发布时间：2018-04-20 21:00

本文选题：梅尼埃病 + 庆大霉素　；参考：《临床耳鼻咽喉头颈外科杂志》2017年02期

【摘要】：目的:研究鼓室注射低剂量庆大霉素与地塞米松治疗难治性梅尼埃病的疗效与安全性。方法:将70例单侧难治性梅尼埃病患者随机分成庆大霉素组和地塞米松组,各35例,分别鼓室注射低剂量庆大霉素和地塞米松。庆大霉素组使用1ml硫酸庆大霉素(40g/L)与0.5ml 5%碳酸氢钠混合配制成浓度为26.7g/L(pH=6.4)的庆大霉素缓冲液,每次注射0.5ml,每周1次,共2周;地塞米松组在第1天和第2天重复注药5mg,以后每周1次,每次注入5mg,4周为1个疗程。随访2年后研究眩晕控制率、纯音听阈测听结果、眩晕障碍量表和耳鸣残疾量表评分。结果:庆大霉素组34例完成随访,眩晕控制A级27例,B级5例,而地塞米松组32例完成随访,A级和B级分别为13例和6例,2组差异有统计学意义(χ~2=11.330,P0.05)。2组患者治疗后的平均听阈及耳鸣残疾量表评分差异无统计学意义(t=1.737、-0.197,P0.05)。结论:对于单侧难治性梅尼埃病患者,鼓室注射低剂量庆大霉素能够有效控制眩晕的发作,且听力恶化的概率很低。
[Abstract]:Objective: to study the efficacy and safety of low-dose gentamicin and dexamethasone in the treatment of refractory Meniere disease. Methods: 70 patients with unilateral refractory Meniere's disease were randomly divided into gentamicin group and dexamethasone group, 35 cases each. Low dose gentamicin and dexamethasone were injected into the tympanic cavity. In the gentamicin group, gentamicin buffer (26.7g 路L ~ (-1) L ~ (-1)) was prepared by mixing gentamicin sulfate (40 g / L) with 0.5ml (5% sodium bicarbonate). 0.5 ml of gentamicin was injected once a week for 2 weeks. In the dexamethasone group, 5 mg of dexamethasone was injected repeatedly on day 1 and day 2, then once a week for 4 weeks as a course of treatment. After 2 years follow-up, the control rate of vertigo, the results of pure tone audiometry, vertigo disorder scale and tinnitus disability scale were studied. Results: in gentamicin group, 34 cases were followed up, 27 cases of vertigo were controlled in grade A and 5 cases were in grade B. In the dexamethasone group, there were significant differences in the mean hearing threshold and tinnitus disability scale score after treatment in 32 cases of Dexamethasone group and 6 cases of Dexamethasone group (13 cases and 6 cases respectively) after treatment (蠂 ~ 2 = 11.330) and the score of tinnitus disability scale was 1.737- 0.197P _ (0.05). Conclusion: in patients with unilateral refractory Meniere disease, low dose gentamicin injection into the tympanic chamber can effectively control the onset of vertigo, and the probability of hearing deterioration is very low.
【作者单位】：河南医学高等专科学校护理系;河南中医药大学第一附属医院耳鼻咽喉科;
【基金】：国家自然科学基金项目(No:81403439) 河南省高等学校重点科研项目计划(No:15B310005)
【分类号】：R764.33

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