發(fā)布時(shí)間：2019-04-24 14:29

【摘要】：目的：客觀評(píng)價(jià)鼓室注射曲安奈德聯(lián)合鹽酸氨溴索與鼓室注射地塞米松聯(lián)合鹽酸氨溴索或鼓膜置管治療分泌性中耳炎（secretory otitismedia,SOM）的有效性和安全性。 方法：通過檢索PubMed、Embase、Medline、相關(guān)期刊論文（CNKI）、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫，收集關(guān)于鼓室注射曲安奈德聯(lián)合鹽酸氨溴索與鼓室注射地塞米松聯(lián)合鹽酸氨溴索或鼓膜置管對(duì)照治療分泌性中耳炎的相關(guān)文獻(xiàn)。嚴(yán)格制定納入和排除標(biāo)準(zhǔn)后對(duì)相關(guān)文獻(xiàn)進(jìn)行篩選，對(duì)納入的文獻(xiàn)進(jìn)行嚴(yán)格的質(zhì)量評(píng)價(jià)，2名研究員分別進(jìn)行數(shù)據(jù)提取，，對(duì)所提取的數(shù)據(jù)用RevMan5.2軟件進(jìn)行Meta分析。 結(jié)果：5個(gè)隨機(jī)對(duì)照研究（RCT）共615耳納入研究。在5個(gè)對(duì)照研究中，治療組（鼓室注射曲安奈德聯(lián)合鹽酸氨溴索）的療效和對(duì)照組（鼓室注射地塞米松聯(lián)合鹽酸氨溴索）比較：比值比（odds ratio,OR）為4.25,95%confidence interval（95%CI）為（2.71，6.66），P0.01；其中2個(gè)對(duì)照研究，治療組（鼓室注射曲安奈德聯(lián)合鹽酸氨溴索）與對(duì)照組（鼓膜置管）的療效及并發(fā)癥比較：OR（95%CI）1.67（0.61，4.60），P=0.32及OR（95%CI）0.16（0.03，0.94），P=0.04。 結(jié)論：在分泌性中耳炎的治療中，鼓室注射曲安奈德聯(lián)合鹽酸氨溴索的療效優(yōu)于地塞米松聯(lián)合鹽酸氨溴索；鼓室注射曲安奈德聯(lián)合鹽酸氨溴索能有效降低患者氣導(dǎo)平均聽閾及骨導(dǎo)聽閾25dB的發(fā)生率。鼓室注射曲安奈德聯(lián)合鹽酸氨溴索的療效與鼓膜置管的相當(dāng)，但并發(fā)癥發(fā)生率低于鼓膜置管。因此鼓室注射曲安奈德聯(lián)合鹽酸氨溴索治療分泌性中耳炎值得臨床推廣。
[Abstract]:Objective: to evaluate the efficacy and safety of tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride and dexamethasone combined with ambroxol hydrochloride or tympanic membrane catheterization in the treatment of secretory otitis media (secretory otitismedia,SOM). Methods: through searching PubMed,Embase,Medline, Chinese journal full-text database (CNKI), Wanfang database and Vip database. Literature on the treatment of secretory otitis media by tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride and tympanic injection of dexamethasone combined with ambroxol hydrochloride or tympanic membrane catheterization was collected. After strictly formulating the standards of inclusion and exclusion, the relevant documents were screened, the quality of the included documents was evaluated strictly, the data were extracted by two researchers, and the extracted data were analyzed by Meta with RevMan5.2 software. Results: a total of 615 ears of (RCT) were included in 5 randomized controlled studies. In five control studies, the efficacy of treatment group (tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride) was compared with that of control group (tympanic injection of dexamethasone combined with ambroxol hydrochloride): ratio of (odds ratio, OR was 4.25, 95% confidence interval (95%CI) was (2.71, 6.66), P0.01; The efficacy and complications of the treatment group (tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride) and the control group (tympanic membrane catheterization) were compared with those of the control group (: OR (95%CI) 1.67 (0.61, 4.60). P < 0. 32 and OR (95%CI) 0. 16 (0. 03, 0. 94), P < 0. 04. Conclusion: in the treatment of secretory otitis media, tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride is superior to dexamethasone combined with Ambroxol hydrochloride. Tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride could effectively reduce the incidence of mean auditory threshold and bone conduction threshold 25dB in patients. Tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride was similar to that of tympanic membrane catheterization, but the incidence of complications was lower than that of tympanic membrane catheterization. Therefore, tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride in the treatment of secretory otitis media is worthy of clinical promotion.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R764.21

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 江剛,劉永紅;成人分泌性中耳炎鼓膜置管的遠(yuǎn)期療效[J];第一軍醫(yī)大學(xué)學(xué)報(bào);2004年01期

2 李希平;戴海江;牟文清;;分泌性中耳炎的治療現(xiàn)狀與思考[J];中國耳鼻咽喉頭頸外科;2007年08期

3 何本均;;鼓室內(nèi)注射曲安奈德和鹽酸氨溴索治療分泌性中耳炎的療效觀察[J];海峽藥學(xué);2012年05期

4 丁元萍,孫曉衛(wèi),丁壽玲,陳瑛;慢性分泌性中耳炎中耳乳突手術(shù)治療的探討[J];山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2005年08期

5 劉陽云;孫正良;李正賢;江文;馮秀榮;;咽鼓管置管在治療鼻咽癌放療后分泌性中耳炎中的價(jià)值[J];山東大學(xué)耳鼻喉眼學(xué)報(bào);2006年04期

6 侯森;楊海珍;;鹽酸氨溴索治療分泌性中耳炎療效的Meta分析[J];山東大學(xué)耳鼻喉眼學(xué)報(bào);2012年03期

7 周宣巖;陶謙;張峰;高振峰;王玉芝;呂凌燕;;鼓室注射曲安奈德和鹽酸氨溴索治療分泌性中耳炎療效分析[J];聽力學(xué)及言語疾病雜志;2009年04期

8 陳水安;何可玲;;鼓膜置管和穿刺治療兒童分泌性中耳炎療效觀察[J];中國眼耳鼻喉科雜志;2008年02期

9 趙禮君;金曉鋒;;咽鼓管置管治療鼻咽癌放療后分泌性中耳炎92例[J];中國眼耳鼻喉科雜志;2010年01期

10 俞颯;;不同方法治療分泌性中耳炎的療效比較[J];中國眼耳鼻喉科雜志;2011年03期

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