摘要
目的观察糜蛋白酶灌注联合自体听骨链重建对慢性中耳炎听力恢复情况的影响。方法选取100例慢性中耳炎患者作为研究对象,按照随机数字表法将患者分为重建组和联合组,每组50例。两组患者均实施自体听骨链重建术治疗,联合组在此基础上经鼓膜下置管灌注糜蛋白酶配合治疗,比较两组患者的炎症因子、免疫指标、听力恢复情况及并发症发生情况。结果治疗后,联合组的肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、白细胞介素-8(IL-8)的水平均低于重建组,差异有统计学意义(P<0.05);联合组T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)的水平均高于重建组(P<0.05);联合组的气导阈值、气骨导差值均低于重建组,而静态声顺值高于重建组(P<0.05);联合组的纯音听阈值、咽鼓管功能障碍症状评分(ETDQ-7)均低于重建组(P<0.05);联合组的并发症发生率低于重建组(P<0.05)。结论经鼓膜下置管灌注糜蛋白酶联合自体听骨链重建能减轻慢性中耳炎患者的炎症反应,并增强免疫功能,对促进患者听力恢复,降低并发症发生风险均有积极意义。
Objective To observe the effects of chymotrypsin infusion combined with autologous ossicular chain reconstruction on hearing recovery in the patients with chronic otitis media.Methods 100 patients with chronic otitis media were randomly divided into the reconstruction group and combination group,with 50 cases in each group.Both groups of patients underwent autologous ossicular chain reconstruction surgery,while the combined group were treated with chymotrypsin through a tube placed under the tympanic membrane.The inflammatory factors,immune indicators,hearing recovery,and incidence of complications were compared between the two groups.Results The levels of tumor necrosis factor in the combination group-α(TNF-α),procalcitonin(PCT)and interleukin-8(IL-8)in the reconstruction group were lower than those in the reconstruction group,showing a statistically significant difference(P<0.05).The T lymphocyte subsets CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the combination group were higher than those in the reconstruction group(P<0.05).The air conduction threshold and air bone conduction difference of the combined group were lower than those in the reconstruction group,and the static acoustic compliance value was higher than that in the reconstruction group(P<0.05).The pure tone hearing threshold and eustachian tube dysfunction symptom score(ETDQ-7)in the combined group were lower than those in the reconstruction group(P<0.05).The incidence of complications in the combined group was lower than that in the reconstruction group,and the difference was statistically significant(P<0.05).Conclusion Perfusion of chymotrypsin combined with autologous ossicular chain reconstruction through a tube placed under the tympanic membrane alleviates the inflammation,enhances immune function,promotes hearing recovery,and reduces the risk of complications in patients with chronic otitis media.
作者
乔琼显
苏振丽
廖天龙
QIAO Qiongxian;SU Zhenli;LIAO Tianlong(Department of Operating,Nanyang First People′s Hospital,Nanyang 473000,China)
出处
《华夏医学》
CAS
2024年第5期155-160,共6页
Acta Medicinae Sinica
基金
河南省医学科技攻关项目(SBGJ202101126)。
关键词
慢性中耳炎
自体听骨链重建
糜蛋白酶灌注
炎症反应
听力水平
chronic otitis media
autologous ossicular chain reconstruction
perfusion of chymotrypsin
inflammatory response
hearing level
