局部类固醇使用是否会增加随后耳整形的风险?
Lawrance Lee1, Mihai A Bentan, Daniel H Coelho
1Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia.
概括
局部类固醇添加到抗生素用于性耳中炎稍微增加残留的耳膜穿孔的风险. 这种风险必须与治疗耳部感染的组合治疗的益处相平衡.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 药理学 药理学是指药理学的学科.
- 医学研究 医学研究
背景情况:
- 辅助性中耳炎的治疗通常涉及局部抗生素.
- 将局部类固醇添加到抗生素治疗中是常见的,但其对耳膜愈合的影响尚未完全理解.
- 剩余的耳膜穿孔是一种潜在的并发症.
研究的目的:
- 评估局部类固醇与抗生素对耳膜 (TM) 愈合的长期影响.
- 评估在治疗性中耳炎后残留的TM穿孔的风险.
主要方法:
- 通过TriNetX研究网络使用电子健康记录进行回顾性队列研究.
- 确定了感染 (H66) 或未感染 (H72) TM 穿孔的成年患者.
- 治疗组包括单独的欧洛素和西普罗洛素/德甲;2年内耳 tympanoplasty 是主要的结局.
主要成果:
- 在感染的TM穿孔中,西普洛克萨/德克萨米他显示了较高的后续 tympanoplasty 的率 (1.12%) 与 ofloxacin (0.76%).
- 在非感染的TM穿孔中,西普洛克萨/德克萨也显示了与奥洛克萨 (5.67%) 相比, tympanoplasty (6.87%) 的发生率显著增加.
- 这两项发现均具有统计学意义 (p < 0.05).
结论:
- 治疗急性性中耳炎时使用西普罗夫洛克萨/德克萨的联合治疗与残留TM穿孔风险的小,但统计学上显著的增加有关.
- 这种穿孔风险增加的临床意义需要与局部类固醇抗生素组合的治疗和症状优势进行权衡.
- 进一步的研究可能会澄清中耳炎的最佳治疗策略.
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