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目的:分析小剂量庆大霉素鼓室内注射治疗难治性梅尼埃病眩晕的疗效。方法:19例单侧难治性梅尼埃病患者显微镜下鼓室内注射庆大霉素,根据床旁试验(自发性眼震、摇头实验、甩头试验),听力变化或患者主观症状来决定3周后是否需要再次注射。结果:19例患者中17例眩晕能得到控制,眩晕控制率89%,其中5例患者经1次注射后眩晕就得到控制;8例患者2次注射后眩晕达到控制,其中1例患者因不能忍受耳内肿胀感,要求进一步治疗,行内淋巴囊减压后,症状缓减;有4例患者经3次注射后眩晕得到控制;另外2例患者注射2次后眩晕无改善,要求终止治疗。2例患者注射后听力好转,14例患者注射后听力无变化,3例患者(15%)注射后听力进一步下降。结论:运用小剂量鼓室内庆大霉素注射治疗难治性梅尼埃病眩晕,1次注射后观察3周决定再次注射的必要性,结果显示这一治疗方案既能有效控制眩晕的发作,又能降低听力损伤的风险。
Objective: To analyze the curative effect of intragastric injection of gentamicin at low dose on patients with refractory Meniere’s disease and vertigo. METHODS: Nineteen patients with unilateral refractory Meniere’s disease underwent a tympanic injection of gentamicin under a microscope, which was determined on the basis of a bedside test (spontaneous nystagmus, shaking head test, shatter test), hearing changes or subjective symptoms of the patient After 3 weeks need to re-injection. Results: In 19 patients, vertigo was controlled in 17 cases and vertigo control rate was 89%. Five of the patients were controlled by dizziness after one injection. In the eight patients, dizziness was controlled after two injections. One patient was unable to get dizziness Endured swelling of the ear, requiring further treatment, the line of lymphatic sac decompression, the symptoms ease; 4 patients after 3 injections dizziness was controlled; the other 2 patients after injection 2 dizziness no improvement, requiring termination of treatment. Two patients had better hearing after injection, 14 patients had no change in hearing after injection, and 3 patients (15%) had further hearing loss after injection. Conclusion: The use of low-dose intravenous injection of gentamicin in the treatment of refractory Meniere’s disease dizziness, 1 injection after 3 weeks to determine the need for re-injection, the results show that this treatment can effectively control the onset of dizziness, But also reduce the risk of hearing loss.