鼓气球鼓室充气治疗梅尼埃病疗效观察

The Intratympanic Inflation by Tympanum Inflatable Balloon for Meniere's Disease

张运波;习国平;王彩君;赵秀云;梁佳;王毅;

1:河北省邯郸市第三医院耳鼻咽喉科

摘要

目的探讨经鼓膜置管鼓气球鼓室充气治疗梅尼埃病的疗效。方法将36例确诊为Ⅱ-Ⅲ期(按0.25、0.5、1、2、3kHz平均听阈分期:Ⅱ期平均听阈2540dB HL,Ⅲ期平均听阈4140dB HL,Ⅲ期平均听阈4170dB HL)梅尼埃病发作期患者随机分为鼓气组和对照组,每组18例;对照组Ⅱ期6例,Ⅲ期12例,在耳内镜下行鼓膜置管后,鼓室灌注甲泼尼龙0.5ml,每3天灌注一次,共三次;鼓气组Ⅱ期5例,Ⅲ期13例,在耳内镜下行鼓膜置管后,应用鼓气球鼓室充气治疗,每次鼓气670dB HL)梅尼埃病发作期患者随机分为鼓气组和对照组,每组18例;对照组Ⅱ期6例,Ⅲ期12例,在耳内镜下行鼓膜置管后,鼓室灌注甲泼尼龙0.5ml,每3天灌注一次,共三次;鼓气组Ⅱ期5例,Ⅲ期13例,在耳内镜下行鼓膜置管后,应用鼓气球鼓室充气治疗,每次鼓气68次,每天4次,至病情缓解;两组均同时给予常规改善微循环、营养神经治疗,两组均保留置管2年,发作期重复上述治疗;随访188次,每天4次,至病情缓解;两组均同时给予常规改善微循环、营养神经治疗,两组均保留置管2年,发作期重复上述治疗;随访1824个月,观察患者眩晕、活动能力、听力及耳鸣变化。结果鼓气组6例眩晕完全控制(A级),10例眩晕基本控制(B级),2例眩晕部分控制(C级),眩晕有效控制率为88.89%(16/18);对照组3例眩晕完全控制(A级),7例眩晕基本控制(B级),8例眩晕部分控制(C级),眩晕有效控制率为55.56%(10/18),鼓气组眩晕有效控制率高于对照组(χ2=4.985,P<0.05)。两组患者耳鸣及纯音平均听阈治疗后与治疗前比较差异无统计学意义(P>0.05)。两组治疗后活动能力均明显改善,差异无统计学意义(P>0.05)。结论应用鼓膜置管后鼓气球鼓室充气治疗Ⅱ、Ⅲ期梅尼埃病患者,其眩晕有效控制率高,活动能力明显改善,但耳鸣及听力改善不明显。

关键词

梅尼埃病;眩晕;鼓膜置管;鼓室充气

基金项目(Foundation):

作者

张运波;习国平;王彩君;赵秀云;梁佳;王毅;

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1河北省邯郸市第三医院耳鼻咽喉科

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