耳内镜下鼓室成形术并鼓室灌注激素对慢性单纯化脓性中耳炎的疗效分析OA
Efficacy of endoscopic tympanoplasty with intratympanic steroids perfusion in the treatment of chronic simple suppurative otitis media
目的 通过比较慢性单纯化脓性中耳炎单纯行耳内镜下鼓室成形术与术中灌注激素不同方案,收集术前术后气导听阈、骨导听阈、炎症因子表达情况、疼痛、耳鸣、焦虑、抑郁等相关数据,探讨分析其疗效.方法 选取2023年1月至2024年5月蚌埠医科大学第一附属医院收治的45例慢性单纯化脓性中耳炎患者为研究对象,其中男性21例,女性24例,年龄26～78岁,平均年龄(51.44±11.10)岁.分为对照组(单纯行耳内镜下耳屏软骨内置法鼓室成形术I型)、地塞米松组(术中灌注地塞米松)和布地奈德组(术中灌注布地奈德),收集术前术后气导听阈、骨导听阈、中性粒细胞/淋巴细胞比值、C反应蛋白数值、疼痛视觉模拟评分量表、中文版耳鸣残疾评估量表、焦虑自评量表和抑郁自评量表的评分等级,采用SPSS 27.0对数据进行统计学检验.结果 3组患者术后1个月各项指标均有所改善,地塞米松组和布地奈德组在多个指标上均优于对照组(P<0.05),但地塞米松组在C反应蛋白数值、视觉疼痛评分量表、中文版耳鸣残疾评估量表及焦虑自评量表评分上与对照组无显著差异(P>0.05).布地奈德组在除气导、骨导听阈外的各项指标上均优于地塞米松组(P<0.05).两组间气导、骨导听阈改善无显著差异(P>0.05).术后3个月无显著差异(P>0.05).结论 慢性单纯化脓性中耳炎行耳内镜鼓室成形术联合灌注激素在短期内对患者的听力、炎症、疼痛、耳鸣、焦虑、抑郁的改善优于对照组,且布地奈德组较地塞米松组效果更明显.
Objective To report outcomes of endoscopic tympanoplasty with intraoperative steroids infusion in patients with chronic simple suppurative otitis media,including air-and bone-conduction thresholds,expression of inflammatory factors,pain,tinnitus,anxiety and depression.Methods Forty-five patients with chronic simple suppurative otitis media admitted to the First Affiliated Hospital of Bengbu Medical University from January 2023 to May 2024 were assigned to receive endoscopic tympanoplasty with built-in otocanal cartilage type I only(control group),with intraoperative dexamethasone infusion(dexamethasone group),or with budesonide infusion(budesonide group).Pre-and postoperative data including air-and bone-conduction thresholds,neutrophil-to-lymphocyte ratio,C-reactive protein,visual analogue scale,tinnitus handicap inventory-Chinese version,self-rating anxiety scale,and self-rating depression scale were collected.Statistical analysis was performed using the SPSS 27.0 software.Results All patients showed improvements in all indexes at 1 month,while patients receiving intraoperative dexamethasone or budesonide infusion outperformed the control group by several indexes(P<0.05)although not between themselves as measured by C-reactive protein,visual analogue score,tinnitus handicap inventory-Chinese version and self-rating depression scale scores(P>0.05).The budesonide group demonstrated better outcomes compared to the dexamethasone group(P<0.05),except for the air-conduction and bone-conduction thresholds,where no significant difference was found(P>0.05).The differences were no longer significant at 3 months(P>0.05).Conclusions Endoscopic tympanoplasty combined with intraoperative steroids infusion(particularly budesonide)can provided short-term outcome superiority in hearing improvement and control of inflammation,pain,tinnitus,anxiety and depression in patients with chronic simple suppurative otitis media compared to without.These findings may help plan clinical treatment strategies.
方文静;程忠强;江涛;许亚佳;葛思辰;姚卫格;蒋成义
蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099蚌埠医科大学第一附属医院耳鼻咽喉头颈外科,蚌埠 233099
慢性单纯化脓性中耳炎激素炎症因子耳鸣焦虑抑郁程度
chronic simple suppurative otitis mediahormoneinflammatory factortinnitusdegree of anxiety and depression
《中华耳科学杂志》 2026 (2)
101-106,6
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