鼓室注射糖皮质激素治疗伴持续耳鸣的难治性突发性聋疗效观察  

Effects of Intratympanic Injection for Treatment of Profound Sudden Hearing Loss with Persistent Tinnitus

作　　者：欧阳杰[1] 黄永望[1] 高晓葳[1] 李超[1] Ouyang Jie;Huang Yongwang;Gao Xiaowei;Li Chao(Department of Otolaryngology,the Second Hospital of Tianjin Medical University,Tianjin,300211,China)

机构地区：[1]天津医科大学第二医院耳鼻咽喉科,天津300211

出　　处：《听力学及言语疾病杂志》2018年第4期347-349,共3页Journal of Audiology and Speech Pathology

摘　　要：目的比较鼓室注射甲泼尼龙琥珀酸钠与甲泼尼龙琥珀酸钠加利多卡因治疗伴持续耳鸣的难治性突发性聋的疗效。方法选择经常规全身用药治疗两周无效的伴持续耳鸣的难治性突发性聋患者84例84耳,随机分为治疗组和对照组,每组42例42耳。治疗组鼓室注射甲泼尼龙琥珀酸钠0.4ml和利多卡因注射液0.1ml,对照组注射甲泼尼龙琥珀酸钠0.4ml,每2天注药1次,共5次,治疗10天后比较两组患者耳鸣疗效及0.5~4kHz气导纯音平均听阈差异。结果治疗10天后两组气导平均听阈都较治疗前下降,治疗组由63.27±15.35dB HL下降至47.83±14.58dB HL,对照组由65.24±13.46dB HL下降至53.56±15.79dB HL,治疗组听力改善总有效率(61.90%,26/42)优于对照组(42.86%,18/42),差异有统计学意义(P<0.05);两组耳鸣程度均较治疗前减轻,治疗组有效率73.81%(31/42),对照组有效率52.38%(22/42),差异有统计学意义(P<0.05)。结论激素鼓室给药可以作为挽救性治疗应用于伴持续耳鸣的难治性突发性聋患者,且甲泼尼龙琥珀酸钠和利多卡因联合注射效果更显著。Objective To compare the effect of intratympanic injection of methylprednisolone and methylprednisolone combined with lidocaine in treatment of sudden deafness with persistent tinnitus.Methods A total of 84 patients(84 ears)with sudden deafness and persistent tinnitus after two weeks of treatment with normal systemic therapy showed no recovery,they were divided into treatment group and control group,each group had 42 patients.The treatment group was injected with methylprednisolone combined with lidocaine injection,and the control group was injected with methylprednisolone.After 10 days of treatment,the tinnitus and average auditory threshold differences were compared between the two groups.Results The average hearing thresholds of the treatment group and the control group were decreased after treatment(the treatment group decreased from 63.27±15.35 dB HL to 47.83±14.58 dB HL,the control group decreased from 65.24±13.46 dB HL to 53.56±15.79 dB HL).The curative effect rate in the treatment group(61.9%)was significantly better than that of in the control group(52.38%).The extent of tinnitus was reduced(the effectiveness of the treatment group was 73.81%,the effective rate in the control group was 52.38%),and the difference was statistically significant.Conclusion Intratympanic injection can be applied to patients with refractory sudden deafness with continuous tinnitus,and the combination of methylprednisolone sodium succinate and lidocaine injection is more effective.

关 键 词：突发性聋 耳鸣 鼓室注射 甲泼尼龙 利多卡因 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]