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目的探讨豚鼠中等强度冲击波负压重复暴露后,高压氧和(或)地塞米松+甲钴铵对内耳损伤的治疗效果。方法32只豚鼠于实验性冲击波负压重复暴露3次后,立即分别给予高压氧治疗、肌注地塞米松+甲钴胺治疗、肌注地塞米松+甲钴胺+高压氧治疗,对照组不接受任何治疗。各治疗组动物于治疗前、治疗后2小时~21天分别测试听性脑干反应(ABR)阈值,在光镜和扫描电镜下观察耳蜗毛细胞形态学改变,并将其与对照组进行对比分析。结果实验性冲击波负压重复暴露后即刻,各治疗组动物ABR阈值明显升高(P<0.01),治疗21天后呈部分恢复。治疗21天后,各治疗组动物耳蜗毛细胞缺失少于对照组。在上述3种治疗方案中,以地塞米松+甲钴胺+高压氧联合应用对听器损伤的治疗效果最为明显。结论在中等强度冲击波负压重复暴露造成豚鼠内耳损伤后,及时给予高压氧吸入及地塞米松和甲钴胺2种药物联合治疗,可有效促进听力功能的恢复并减轻耳蜗毛细胞损害程度。
Objective To investigate the therapeutic effect of hyperbaric oxygen and dexamethasone + mecobalamin on the damage of inner ear in guinea pigs exposed to repeated negative shocks of medium intensity shock wave. Methods Thirty-two guinea pigs were exposed to hyperbaric oxygen immediately after exposure to experimental negative pressure for three times, intramuscularly with dexamethasone and mecobalamin, intramuscular injection of dexamethasone and mecobalamin plus hyperbaric oxygen, and control group Do not accept any treatment. Before treatment, the animals in each treatment group were tested for threshold of auditory brainstem response (ABR) 2 hours to 21 days after treatment, morphological changes of cochlear hair cells were observed under light microscope and scanning electron microscope, and compared with the control group analysis. Results Immediately after repeated negative exposure to experimental shock waves, ABR thresholds in all treatment groups were significantly increased (P <0.01), and partially recovered after 21 days of treatment. After 21 days of treatment, there was less loss of hair cells in cochlea in all treatment groups than in control group. In the above three kinds of treatment options, the combination of dexamethasone + mecobalamin + hyperbaric oxygen treatment of the most obvious treatment of hearing loss. Conclusions After repeated exposure to negative shock with medium intensity shock wave, the inhalation of hyperbaric oxygen and the combined treatment of dexamethasone and mecobalamin twice a day can effectively promote the recovery of hearing function and alleviate the damage of cochlear hair cells.