全身联合鼓室内注射地塞米松治疗突发性聋的疗效分析  

Analysis of efficacy of systemic and intratympanic dexamethasone combination therapy in the treatment of sudden sensorineural hearing loss

作　　者：倪茂美[1] 刘蕾[1] 赵睿[1] 聂敏[1] 杨秀海[1] NI Maomei;LIU Lei;ZHAO Rui;NIE Min;YANG Xiuhai(Department of Otorhinolaryngology Head and Neck Surgery, Guizhou Provincial People＇s Hos- pital, Guiyang, 550002, Chin)

机构地区：[1]贵州省人民医院耳鼻咽喉头颈外科,贵阳550002

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第9期656-660,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:观察全身联合鼓室内注射地塞米松对突发性聋的治疗效果。方法:纳入突发性聋患者98例,随机分为3个组:全身激素治疗组(39例)、鼓室注射治疗组(28例)、联合用药治疗组(31例)。所有患者均接受银杏达莫注射液、甲钻胺和质子泵抑制剂药物治疗。所有患者治疗前后均进行听力测试。结果:98例患者中,共计65例(66.3%)治疗有效,3组间的治疗有效率差异无统计学意义(P=0.61),眩晕加耳鸣的患者治疗有效率低(P=0.00),有家族史者治疗有效率低于无家族史者(P=0.02);治疗有效率与患者的耳聋程度(P=0.68)及听力曲线图(P=0.28)无明显相关性。结论:静脉注射地塞米松、鼓室内注射地塞米松及二者联合治疗突发性聋,3种方法间无明显的疗效差异。Objective：To evaluate the effect of systemic and intratympanic dexamethasone combination therapy on sudden deafness.Method：A total of 98 patients randomly divided into three groups：an intravenous corticosteroid（systemic corticosteroid monotherapy group）;an intratympanic corticosteroid（IT monotherapy group）;and a combination therapy group（IT plus systemic combination group）.All patients were treated additionally with ginkgo-damole and mecobalamine and proton pomp inhibitor.An audiometry was performed before and after the therapies in all patients.Result：Of the total of 98 patients,39 received systemic corticosteroids,28 received intratympanic（IT）corticosteroids,and 31 received a combination of the two.A total of 65 patients（66.3%）responded positively to corticosteroid therapy.No significant differences were observed between the three groups（systemic group,IT and combination therapy group）in their overall response to treatment（P=0.61）.Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment（P=0.00）.Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment（P=0.02）.The effective rate of treatment was not significantly related to the initial severity of hearing loss（P=0.68）and pattern（P=0.28）.Conclusion：There was no significant difference in treatment between systemic,intratympanic,and combined corticosteroid therapy for sudden hearing loss.

关 键 词：突发性聋 全身给药 鼓室给药 激素治疗 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]