不同途径局部应用糖皮质激素治疗SSNHL的临床效果  

Effects of glucocorticoid locally applied in different ways in treatment of SSNHL

作　　者：姚亮[1] 李继红[1] 任同力[2] 

机构地区：[1]无锡市人民医院耳鼻咽喉科,江苏无锡214000 [2]复旦大学附属眼耳鼻喉医院

出　　处：《西南国防医药》2017年第6期555-557,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨经鼓室注射和经耳后筛区局部应用糖皮质激素治疗突发性耳聋(SSNHL)的临床效果。方法选取126例SSNHL患者为研究对象,随机分为鼓室内组(64耳)和耳后筛区组(62耳)。鼓室内组给予鼓室内注射甲强龙,耳后筛区组给予耳后筛区注射甲强龙,两组均为每隔4 d治疗1次,共3次,甲强龙总用量120 mg。观察两组听力、耳鸣改善情况及治疗过程的不良反应。结果与治疗前相比,两组治疗后气导纯音听阈均值(PTA)均显著降低(P<0.05);而两组治疗后PTA降低程度相比,无统计学差异(P>0.05)。鼓室内组的治疗总有效率为81.3%,耳后筛区组为83.9%,两组相比无统计学差异(P>0.05)。鼓室内组的耳鸣改善总有效率为90.6%,耳后筛区组的耳鸣改善总有效率为91.9%,两组相比也无统计学差异(P>0.05)。结论经鼓室注射和经耳后筛区局部应用甲强龙治疗SSNHL疗效相当,但鼓室注射是一项鼓室有创操作,因此,推荐使用耳后筛区注射治疗SSNHL。Objective To explore the effects of glucocorticoid locally applied by intratympanic injection and via retroauricular cribriform area in the treatment of sudden sensorineural hearing loss （SSNHL）. Methods A total of 126 cases of SSNHL patients were selected and randomly divided into an intratympanic group （64 ears） and a retroauricular cribriform area group （64 ears）. The intratympanic group was treated with methylprednisolone （MP） by intratympanic injection, ＂while the retroauricular cribriform area group was treated with MP by injection via retroauricular cribriform area. The two groups were treated once every four days and for three times in total. The total dosage of MP was 120 mg. The improvement of hearing and tinnitus and adverse reactions during treatment in the two groups were observed. Results The post-treatment pure tone averages （PTA） in the two groups decreasedsignificantly （P 〈 0.05）; there was no statistical difference in the reduction of PTA between the two groups （P 〉 0.05）. The overall response rate （ORR） in the intratympanic group was 81.3% , while that in the retroauricular cribriform area group was 83.9% , showing no statistical difference （P 〉 0.05）. The ORR of tinnitus improvement in the intratympanic group was 90.6% and that in the retroauricular cribrifonn area group was 91.9%, also showing no statistical difference （P 〉 0.05）. Conclusion The treatment of SSNHL with MP locally applied by intratympanic injection and by injection via retroauricular cribriform area shows equivalent effects. However, intratympanic injection is an invasive operation, thus injection in retroauricular cribriform area is recommended for the treatment of SSNHL.

关 键 词：突发性耳聋 鼓室 耳后筛区 甲强龙 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]