单用糖皮质激素治疗突发性耳聋的疗效分析  

The analysis of single use of Glucocorticoids in treatment for Sudden Deafness

作　　者：邓炳辉[1] 林云雁[1] 吴华飞[1] 朱浩标 

机构地区：[1]南方医科大学附属新会医院耳鼻咽喉科,江门529100 [2]江门市新会区第二人民医院耳鼻咽喉科,江门529100

出　　处：《中华耳科学杂志》2012年第3期383-386,共4页Chinese Journal of Otology

摘　　要：目的了解单独使用地塞米松治疗突发性耳聋的治疗效果。方法对2007年1月至2012年3月就诊的病程≥14d、听力损失为中重度以上(0.25、0.5、1、2、4kHz的平均听阈≥56dB)的突发性耳聋患者86例进行回顾性分析:按治疗方法的不同分为3组,A组25例,单独使用地塞米松静脉滴注,qd,首日剂量0.2mg/kg/d,每隔3日减量0.05mg/kg/d;B组32例,在地塞米松使用同A组的基础上,增加使用血塞通注射液5ml,静脉滴注,qd;ATP40mg+辅酶A100U+VitB6100mg,静脉滴注,qd;高压氧治疗,qd;C组29例,除不使用地塞米松外,其余用法同B组;3组疗程均为12d,观察听力恢复情况。结果 A、B两组显效率分别为44.0%和43.8%,差异无统计学意义(P>0.05);有效率分别为88.0%和90.6%,差异无统计学意义(P>0.05),C组显效率和有效率分别为17.2%和55.2%,分别与A、B组比较,均差异有统计学意义(P<0.05);按听力曲线类型比较,A、B组的显效率和有效率均比C组高,但均差异无统计学意义(均P>0.05);3组均无明显的不良反应发生。结论在突发性耳聋的综合治疗中,激素起最主要的作用,单独用药可达到联合用药的疗效率。Objective To study the effects of standalone dexamethasone treatment in sudden deafness. Methods Data from 86 patients diagnosed with sudden deafness （duration ≥14 d, 0.25-0.5-1-2-4 kHz pure tone threshold average 〉156 dB HL） treated during a period from January 2007 to March 2012 were reviewed. Patients were divided into three groups based upon treatment method. Group A （n=25） received intravenous dexamethasone injection once a day （0.2 mg/kg/d on Day 1, with a decrease of 0.05 mg/kg/d every three days）. Group B （n=32） received additional intravenous 5 ml Xuesaitong Injection, 40 mg ATP, 100U Coenzyme A and 100 mg VitB6 qd, plus everyday hyperbaric oxygen therapy.Group C （n=29） received the same treatment as group B minus dexamethasone. The treatment course was 12 days while hearing recovery was monitored in all groups. Results The rate of significant improvement in Groups A and B was 44.0% and 43.8% respectively （P〉O.O5）,with a total effectiveness rate of 88.0% and 90.6% respectively （P〉0.05）. The rate of significant improvement and total effectiveness rate in group C were 17.2% and 55.2% respectively, lower than Groups A and B （P〈0.05）. Although the rate of significant improvement and total effectiveness rate were higher in Groups A and B than in Group C when compared based upon hearing loss patterns, the differences were not statistically significant. Conclusion It appears that steroids alone play the most important role in the treatment of sudden deafness, providing similar treatment results as drug combinations.

关 键 词：听觉丧失 突发性 糖皮质激素 类固醇 治疗结果 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]