耳鼻喉学课件：meniere_disease梅尼埃病.ppt

* This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. * This is China. It consists of 30 provinces and 5 autonomous regions with a total population of 1.2 billion. 梅尼埃病 Méniére disease 定义 梅尼埃病 一种特发性内耳病 Prosper Méniére 1861年首次报道 临床特征 反复发作的旋转性眩晕 波动性感音神经性耳聋 耳鸣 耳胀满感 流行病学 发病率7.5~157/10万 中青年居多（40~60岁） 性别差异不明显(1 :1.3) 多为单侧（59.5~85%） 病理与机制 基本病理变化 主要发生机制 内淋巴产生和吸收失衡 膜迷路积水 病因及发病机制 膜迷路积水 血管纹、内淋巴囊血管和前庭膜通透性增高 免疫反应等因素引起内淋巴囊炎症、肉芽及循环免疫复合物沉积，干扰内淋巴吸收 内淋巴管或连合管、椭圆囊管或椭圆球囊管任何部位的狭窄阻塞 内耳缺血缺氧 免疫反应 病因及发病机制 过敏反应参与膜迷路积水 内耳自身免疫参与膜迷路积水 病毒感染 内淋巴囊功能紊乱 遗传倾向 多因素 症状 发作性眩晕:突然发作的旋转性眩晕(视物旋转或自身旋转)，伴植物神经系统症状 渐进性听力下降:早期低频感音神经聋，听力波动,间歇期听力正常 耳鸣: 初为低频吹风样，后转为高频蝉鸣样耳鸣 耳胀满感 间歇期表现 眩晕消失 耳鸣消失或减轻 耳聋减轻 检查 电耳镜检查 鼓膜正常 声导抗测试 鼓室