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目的 探讨庆大霉素破坏性治疗单侧梅尼埃病的疗效。方法 选择 2 3例年龄在 2 4～6 1岁的梅尼埃病患者为治疗对象。将患耳置鼓室通气管后 ,每日经中耳通气管注入庆大霉素 ,每次12mg ,3h 1次 ,每日共 5次。注药前检查纯音听力及前庭功能 ,冰水试验反应消失或明显减弱、Frenzel眼镜下观察到破坏性眼震即可停药。 2 3例患者平均用药 2 16mg ,平均治疗时间 3 6d。分别随访 9～ 11年 ,平均 10 2年。结果 2 1例患者眩晕发作消失 (91% ) ,2例仍有发作 ;听力提高或不变17例 (73% ) ,下降 6例 ;耳鸣减轻或消失 15例 (6 6 % ) ,不变 6例 ,加重 2例 ;耳闭减轻或消失 2 1例(91% ) ,无变化 2例。患者恢复工作和生活能力 2 1例 (91% ) ,仍轻度致残 1例 ,重度致残 1例 ,此例经迷路切除术眩晕消失。结论 鼓室应用庆大霉素可以破坏前庭功能并消除眩晕 ,保存耳蜗功能。获得疗效的关键是严格选择适应证 ,密切监视内耳功能 ,掌握用药剂量与停药指征。
Objective To investigate the efficacy of gentamycin in the treatment of unilateral Meniere’s disease. Methods Twenty-three Meniere’s disease patients aged 24 to 61 years old were selected as the treatment subjects. Will suffer from ear tympanic membrane vent tube, daily by the middle ear ventilation tube injection of gentamicin, each 12mg, 3h 1 times, a total of 5 times a day. Pure tone hearing and vestibular function was checked before drug injection. The response to ice water test disappeared or was significantly weakened. Destructive nystagmus was observed under Frenzel glasses. 23 patients with an average of 2,16mg medication, the average treatment time 36d. Follow-up 9 to 11 years, an average of 102 years. Results 21 patients had vertigo episodes (91%), 2 patients still had seizures; 17 patients (73%) had hearing enhancement or no change, 6 patients decreased; tinnitus was reduced or disappeared in 15 patients (6 6%), unchanged 6 Cases, exacerbations in 2 cases; reduced or disappeared in 21 cases (91%), no change in 2 cases. One patient (91%) was still recovering from work and life skills, one was mildly disabled and one was severely disabled. In this case, the dizziness disappeared after labyctomy. Conclusion The application of gentamicin in the tympanic cavity can destroy the vestibular function and eliminate vertigo and preserve the cochlear function. The key to obtaining curative effect is to choose indications strictly, to closely monitor the inner ear function, to master the dosage and withdrawal indications.