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目的探讨鼓膜切开灌洗地塞米松及α-糜蛋白酶治疗分泌性中耳炎(SOM)的临床效果。方法 SOM患者120例140病耳,依据随机分组原则将分为治疗组和对照组各70耳,对照组患耳局麻,耳内镜直视下鼓膜在鼓膜紧张部前下或后下象限弧形切开鼓膜2～3 mm,抽吸出积液;0.9%氯化钠溶液注入冲洗;观察组切开鼓膜后注入地塞米松针5 mg和α-糜蛋白酶针30 mg混合液进行冲洗。结果对两组患者进行随访,时间9个月至3年,平均(13.34±4.56)个月。观察组有效率(92.86%)高于对照组(78.57%)(P<0.05),观察组无明显药物不良反应。结论耳内镜直视下行鼓室镜鼓膜切开术,注入地塞米松针和α-糜蛋白酶针混合液进行冲洗,是治疗分泌性中耳炎是行之有效的方法。
Objective To investigate the clinical effect of eardrum lavage dexamethasone and α-chymotrypsin on secretory otitis media (SOM). Methods 120 patients with 140 cases of SOM ears, according to the principle of randomization will be divided into treatment group and control group of 70 ears, the control group suffered from local anesthesia, under direct endoscopic sinus under the tympanic membrane in the anterior or posterior quadrant quadrant arc The eustachian tube was excised and the effusion was aspirated; the 0.9% sodium chloride solution was infused and rinsed; the observation group was infused with 5 mg dexamethasone needle and 30 mg α-chymotrypsin needle solution after the eardrum was excised. Results The two groups of patients were followed up from 9 months to 3 years with an average of (13.34 ± 4.56) months. The effective rate of the observation group (92.86%) was higher than that of the control group (78.57%) (P <0.05), and the observation group had no obvious adverse drug reaction. Conclusion Endoscopic direct tympanotomy under tympanotomy, injection of dexamethasone needle and a-chymotrypsin mixed solution for irrigation, is the treatment of secretory otitis media is an effective method.