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目的 观察庆大霉素注入鼓室内治疗顽固性梅尼埃病 (Menere’sdisease)的效果。方法 在手术显微镜下 ,经鼓室穿刺 ,注入庆大霉素溶液 (每毫升含庆大霉素 40mg即 4万U) 0 .3ml ,平卧 3 0min ,每日 1次 ,3次为一疗程 ,最多治疗 3疗程。每周复查听力 2次。如听力下降、眩晕减轻或消失 ,应及时停药。如治疗反应不重或听力无明显下降 ,1周后可重复治疗。结果 一疗程后 ,眩晕控制 3 2例( 3 2 5 1) ;二疗程后 ,眩晕消失 45例 ( 4 5 5 1) ;三疗程眩晕消失 49例 ( 4 9 5 1) ,2例无效。大部分病人有不同程度的听力下降 ( 3 5 5 1) ,有 6例听力提高 ,10例听力无变化。经 2～ 8年随访 ,8例 ( 8 5 1)复发 ,但较治疗前症状减轻。其余病人未出现眩晕发作。结论 鼓室注入庆大霉素治疗梅尼埃病 ,方法简单 ,操作方便 ,疗效好 ,病人痛苦小 ,副作用小 ,可在门诊施行。
Objective To observe the effect of injecting gentamicin into the tympanic cavity for the treatment of intractable Meniere’s disease. Methods Under the operating microscope, the tympanic puncture, injection of gentamicin solution (per milliliter containing gentamicin 40mg or 40,000 U) 0.3ml, supine 30min, day 1, 3 times for a course of treatment, Up to 3 courses of treatment. Review the hearing twice a week. Such as hearing loss, vertigo to reduce or disappear, should be promptly discontinued. If the response is not heavy or no significant hearing loss, 1 week after repeated treatment. Results After one course of treatment, vertigo control was performed in 32 cases (3251); after two courses of treatment, vertigo disappeared in 45 cases (4551); 49 cases (4951) in three courses disappeared, and 2 cases were ineffective. Most patients had varying degrees of hearing loss (3 5 5 1), 6 cases of hearing improvement, 10 cases of hearing no change. After 2 to 8 years of follow-up, 8 patients (851) relapsed, but the symptoms were relieved before treatment. The remaining patients did not have a dizziness attack. Conclusion The injection of gentamicin in the tympanum for the treatment of Meniere’s disease is simple, easy to operate and has good curative effect. The patient has little pain and little side effects and can be administered in the clinic.