【摘要】 目的探讨口服和鼓室内注射糖皮质激素治疗分泌性中耳炎(otitis media with effusion,OME)的疗效。方法选择84例病程在8周之内的OME患者(8～56岁)为研究对象,在进行鼓室穿刺抽液及口服抗生素的基础上,随机分成A组,30例34耳,予小剂量短疗程口服泼尼松治疗;B组,30例32耳,予地塞米松鼓室内注射2～4次;C组,24例26耳,口服抗生素,鼓室穿刺抽液。疗程结束后随访3个月。结果A、B两组分别有70.6%和53.1%的患耳在一周内有不同程度好转。治疗一个月后,A、B、C三组的总有效率分别为88.2%(30/34耳)、90.6%(29/32耳)和69.2%(18/26耳);A组与B组总有效率比较差异无统计学意义(P>0.05),但A、B两组与C组总有效率比较差异有统计学意义(P<0.05)。结论口服或鼓室内注射糖皮质激素均为治疗OME的有效方法。更多还原

【Abstract】 Objective To investigate the efficacy of oral administration and intratympanic injection of glucocorticoid in the management of otitis media with effusion(OME). Methods The study included 84 patients,ranging 8 to 56 years in age,with OME of no more than 2 months’ duration. All patients received antibiotic treatment and tympanotomy with 3 months’ follow-up. They were randomly assigned to three groups,namely,the treatment group A (30 patients 34 ears,oral administration of short-term and small dose of prednisone),the treatment group B (30 patients 32 ears,2~4 intratympanic injections of dexamethasone ) and control group(24 patients 26ears). Results 70.6% ears of treatment group A and 53.1% ears of treatment group B showed complete or partial recovery in one week’s therapy. At the end of four weeks,improvement rates were 88.2% (30/34 ears) for treatment group A,90.6% (29/32 ears) for treatment group B,and 69.2% (18/26 ears) in the control group,respectively. Significantly higher improvement rate was obtained in both treatment groups when compared with the control group (P<0.05),but no statistical difference existed between the two treatment groups’ improvement rates(P>0.05). Conclusion Both oral administration and intratympanic injection of glucocorticoid are effective for the treatment of OME. Oral administration of short-term and small dose of glucocorticoid is fast,effective and convenient. Intratympanic injection of glucocorticoid is especially favorable to patients who have contraindications of steroids or those need long-term therapy. The efficacy of both treatments of OME with glucocorticoid in the longer term,howerer,needs further investigation.更多还原