地塞米松鼓室内注射与静脉给药治疗突发性聋的疗效观察  

Observation on curative effect of intratympanic versus intravenous administration of dexamethasone in the treatment of sudden sensorineural hearing loss

作　　者：徐胜辉 郭亿莲[2] 

机构地区：[1]中山市大涌医院耳鼻咽喉科,广东528476 [2]中山市中医院耳鼻咽喉科,广东528400

出　　处：《中国临床新医学》2013年第6期557-559,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的比较地塞米松鼓室内注射与静脉给药治疗突发性聋的临床疗效。方法将180例初次治疗的突发性聋患者分为A组和B组,每组90例,两组根据听力损失程度又分为A1、A2组和B1、B2组,PTA≤70dB患者为A1、B1组,PTA>70dB患者为A2、B2组。A组采用常规疗法加静脉注射地塞米松治疗,B组采用常规疗法加鼓室注射地塞米松治疗,比较各组治疗效果。结果 (1)B组临床疗效和总有效率均优于A组(P均<0.05)。(2)A1组总有效率为72.00%(36/50),A2组总有效率为40.00%(16/40),B1组总有效率为81.25%(39/48),B2组总有效率为61.90%(26/42);A1组与A2组、B1组与B2组及A2组与B2组差异有统计学意义(P<0.05),而A1组与B1组差异无统计学意义(P>0.05)。结论同一种治疗方法,听力损失程度与疗效有密切关系,因此对PTA≤70dB的患者应根据患者的实际情况决定给药途径,而对PTA>70dB的患者,如情况允许应尽可能用鼓室注射地塞米松治疗。Objective To compare the clinical curative effect between intratympanic and intravenous admin- istration of dexamethasone in the treatment of sudden seusorineural hearing loss （SSNHL）. Methods One hundred and eighty patients with SSNHL receiving primary treatment were randomly divided into group A and group B, each group ofgO cases. Then according to the degree of hearing loss, PTA≤70 dB patients were divided into A1 group and B1 group, PTA 〉 70 dB patients divided into A2 group and B2 group. Group A was treated with conventional therapy combined with intravenous therapy of dexamethasone, group B with conventional therapy plus intratympanic adminis- tration of dexamethasone. The therapeutic effect between two groups were compared. Results （ 1 ） The clinical effect and total effective rate in B group were better than those in A group（P all 〈 0.05 ）. （2）A1 group＇ s total effective rate was 72. 00% （36/50）, A2 group＇ s total effective rate was 40.00% （ 16/40）, B1 group＇ s total effective rate was 81.25% （39/48）, B2 group＇ s total effective rate was 61.90% （26/42） ; Between A1 group and A2 group,between B1 group and B2 group and between A2 group and B2 group there were statistically significant difference（ P 〈 0. 05 ）, and between A1 group and B1 group there was no statistically significant difference （ P 〉 0. 05 ）. Conclusion Be- tween the degree of hearing loss and the curative effect there is a close relationship in the same kind of treatment. So to patients with PTA ≤70 dB, it should be necessary to select the route of administration on the basis of the actual sit- uation of patients and to patients with PTA 〉 70dB, if cirumstances permit intratympanic administration of dexametha- sone should be used as far as possible.

关 键 词：突发性聋 静脉注射 鼓室注射 地塞米松 

分 类 号：R764[医药卫生—耳鼻咽喉科]