当前位置:主页 > 医学论文 > 五官科论文 >

不同方式半规管阻塞术治疗顽固性梅尼埃病疗效分析

发布时间:2019-01-10 08:45
【摘要】:目的通过不同方式半规管阻塞术治疗顽固性梅尼埃病的临床观察及疗效分析,对比分析不同阻塞方法对眩晕的控制及听力保留率,为梅尼埃病的个体化最佳治疗方案的选择提供依据。方法回顾性分析2010年12月至2016年1月我院328例行半规管阻塞术的梅尼埃病患者的临床资料。参照梅尼埃病的诊断依据和疗效评估(2006年,贵阳)标准,所有患者均临床诊断为单侧梅尼埃病,行规范化药物保守治疗至少1年以上,但眩晕仍反复发作。其中三个半规管阻塞术302例,两个半规管阻塞术21例,包括水平半规管联合后半规管阻塞15例,水平半规管联合上半规管阻塞6例;一个半规管阻塞术5例,均为水平半规管阻塞。采用纯音测听、前庭双温试验和颈源性前庭诱发肌源性电位(cervical vestibular evokedmyogenic potential,c VEMP)进行听力学和前庭功能评估,通过内耳MRI膜迷路水成像观察阻塞术后膜迷路的形态学改变。结果三个半规管阻塞术对眩晕控制的总有效率为98.0%(296/302),A级81.8%(247/302),B级16.2%(49/302),听力保留率70.2%(212/302);两个半规管阻塞术对眩晕控制的总有效率为85.7%(18/21),A级61.9%(13/21),B级23.8%(5/21),听力保留率76.2%(16/21);一个半规管阻塞对眩晕控制的总有效率为60.0%(3/5),A级40.0%(2/5),B级20.0%(1/5),听力保留率80.0%(4/5)。三个半规管阻塞术眩晕控制有效率高于两个半规管阻塞或一个半规管阻塞术(P0.05)。听力保留率三组之间无明显差异(P0.05)。结论半规管阻塞术是治疗顽固性梅尼埃病的有效方法。三个半规管阻塞术眩晕控制有效率最高。
[Abstract]:Objective to analyze the clinical observation and curative effect of different methods of semicircular canal occlusion in the treatment of refractory Meniere's disease, and to compare the control of dizziness and the rate of hearing retention with different methods of obstruction. To provide the basis for the selection of the best individualized treatment for Meniere's disease. Methods the clinical data of 328 patients with Meniere's disease undergoing semicircular canal occlusion from December 2010 to January 2016 were retrospectively analyzed. According to the criteria of diagnosis and curative effect evaluation of Meniere's disease (2006, Guiyang), all the patients were diagnosed as unilateral Meniere's disease clinically and treated with standardized medicine conservative therapy for at least one year, but the vertigo still recurred repeatedly. Three semicircular canal occlusion in 302 cases, two semicircular canal occlusion in 21 cases, including horizontal semicircular canal combined with posterior semicircular canal occlusion in 15 cases, horizontal semicircular canal combined with upper semicircular canal obstruction in 6 cases. There were 5 cases of semicircular canal obstruction, all of which were horizontal semicircular canal obstruction. Pure tone audiometry, vestibular double temperature test and cervical vestibular evoked myogenic potential (cervical vestibular evokedmyogenic potential,c VEMP) were used to evaluate audiology and vestibular function. Morphological changes of membranous labyrinth after occlusion were observed by MRI membrane labyrinth water imaging of inner ear. Results the total effective rate of three semicircular canal occlusion for vertigo control was 98.0% (296 / 302), A, 81.8%) (247 / 302), B 16.2%, 49 / 302), and the hearing retention rate was 70.2% (212 / 302). The total effective rate of two semicircular canal occlusion for controlling vertigo was 85.7% (18 / 21), A, 61.9%, 13 / 21), B, 23.8%, 5 / 21), and the hearing retention rate was 76.2% (16 / 21). The total effective rate of semicircular canal obstruction for vertigo control was 60.0% (3 / 5), A 40.0%) (2 / 5), B 20.0% (1 / 5), and the hearing retention rate was 80.0% (4 / 5). The vertigo control efficiency of three semicircular canal occlusion was higher than that of two semicircular canal occlusion or semicircular canal occlusion (P0.05). There was no significant difference in hearing retention rate among the three groups (P0.05). Conclusion semicircular canal occlusion is an effective method for the treatment of refractory Meniere disease. Three semicircular canaliculi occlusion of vertigo control efficiency is the highest.
【作者单位】: 山东大学附属省立医院耳鼻咽喉头颈外科 山东省立医院集团眼耳鼻喉医院耳鼻咽喉头颈外科山东省听力重建重点实验室;
【基金】:国家自然科学基金(81200744) 山东省科技发展计划项目(2011GGH21839)~~
【分类号】:R764.9

【相似文献】

相关期刊论文 前10条

1 刘俊秀,谷京城,殷善开,孙连玉;应用微波技术行后半规管阻塞术的实验研究[J];临床耳鼻咽喉科杂志;2001年01期

2 曹振宇,张英;半规管阻塞术[J];国外医学.耳鼻咽喉科学分册;2001年04期

3 刘俊秀;后半规管阻塞术治疗良性阵发性位置性眩晕[J];锦州医学院学报;1999年01期

4 曹振宇,殷善开,张茂椿,黄艳艳;豚鼠半规管阻塞术中听性脑干反应的变化[J];听力学及言语疾病杂志;2002年03期

5 杨新明,卢永德,,殷团芳,陈忠,任基浩,祝道桂,谭微微;后半规管阻塞术对内耳功能与形态影响的实验观察[J];中国耳鼻咽喉颅底外科杂志;1996年01期

6 林枫,王跃建,虞幼军,刘振,刘秋玲;后半规管阻塞术治疗难治性位置性眩晕的远期疗效[J];中国校医;2005年02期

7 朱德民;外半规管阻塞术治疗位置性眩晕的效果[J];国外医学.耳鼻咽喉科学分册;2002年04期

8 ;更正[J];现代临床护理;2013年08期

9 李颖;陈文;陈晓芬;;后半规管阻塞术治疗难治性阵发性位置性眩晕的围手术期护理[J];现代临床护理;2013年06期

10 殷善开,沈平江,柯国欣;后半规管阻塞术治疗难治性位置性眩晕一例[J];中华耳鼻咽喉科杂志;1999年02期

相关会议论文 前5条

1 谷京城;刘俊秀;孙连玉;殷喜开;;应用微波技术行后半规管阻塞术对豚鼠前庭及耳蜗功能的影响(摘要)[A];第三届第二次全国中西医结合耳鼻咽喉科学术大会论文汇编[C];2000年

2 张道宫;樊兆民;韩月臣;王海波;;三个半规管阻塞术治疗51例顽固性梅尼埃病的疗效分析[A];全国耳鼻咽喉头颈外科中青年学术会议论文汇编[C];2012年

3 陈斌;陈正侬;殷善开;;单侧半规管阻塞术后大鼠前庭神经核的Fos表达[A];2010全国耳鼻咽喉头颈外科中青年学术会议论文汇编[C];2010年

4 陈斌;殷善开;;单侧半规管阻塞术后大鼠前庭神经核的Fos表达[A];中华医学会第十次全国耳鼻咽喉-头颈外科学术会议论文汇编(上)[C];2007年

5 于栋祯;;半规管阻塞术中膜半规管损伤对术后听功能的影响[A];华东六省一市耳鼻咽喉-头颈外科学术会议暨2008年浙江省耳鼻咽喉-头颈外科学术年会论文汇编[C];2008年



本文编号:2406116


论文下载
论文发表
教材专著
专利申请


    下载步骤:
    1.微信扫码,备注编号 2406116.
    2.
    点击下载


    本文链接:http://www.bigengculture.com/yixuelunwen/wuguanyixuelunwen/2406116.html

    ×
    论文发表,推荐期刊