鼓室内联合全身应用糖皮质激素治疗突发性聋的Meta分析  

Intratympanic combined with systemic glucocoticoid use for treating sudden hearing loss:a meta-analysis

作　　者：方敏 唐成忠[1] 陈东[1] 徐洁[2] FANG Min;TANG Chengzhong;CHEN Dong;XU Jie(Department of Otorhinolaryngology,Jiangyou Municipal People′s Hospital,Jiangyou,Sichuan 621700,China;Department of Otorhinolaryngology,Head and Neck,Children′s Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/International Scientific and Technological Cooperation Base for Major Diseases of Child Development,Chongqing 400014,China)

机构地区：[1]四川省江油市人民医院耳鼻咽喉科,621700 [2]重庆医科大学附属儿童医院耳鼻咽喉头颈外科/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地,400014

出　　处：《重庆医学》2018年第27期3546-3551,共6页Chongqing medicine

摘　　要：目的系统评价鼓室内联合全身应用糖皮质激素与单纯全身应用糖皮质激素治疗突发性聋的疗效。方法计算机检索Pubmed、Embase、OVID、中国知网数据库、万方数据库,检索时间自各数据库创建到2017年10月,纳入比较鼓室内联合全身应用糖皮质激素与单纯全身应用糖皮质激素治疗突发性聋疗效的随机对照研究。采用RevMan5.2软件包对纳入文献进行Meta分析。结果共纳入15篇随机对照研究,鼓室内联合全身应用糖皮质激素与单纯全身应用糖皮质激素治疗突发性聋的有效率分别为72.70%和51.70%,差异有统计学意义[OR=2.79,95%CI(2.17,3.58),P<0.01];治愈率分别为26.45%和17.18%,差异有统计学意义[OR=1.85,95%CI(1.24,2.78),P<0.01];平均听阈改善值差异有统计学意义[MD=11.41,95%CI(8.40,14.42),P<0.01]。结论鼓室内联合全身应用糖皮质激素较单纯全身应用糖皮质激素疗效好,但是否能作为治疗突发性聋的首选方法,仍需更多临床试验进一步研究。Objective To systematically evaluate the efficacy difference between intratympanic combined with systemic glucocoticoid use and systemic glucocoticoid use for treating sudden hearing loss(SHL).Methods The randomized controlled trials(RCT)about intratympanic combined with systemic glucocoticoid use versus systemic glucocoticoid use for treating SHL were retrieved from Pubmed,Embase,OVID,CNKI and WanFang databases by computer.The retrieval time was from the establishement of the databases to October 2017.The included literatures were performed the meta analysis by using RevMan5.2 software package.Results A total of 15 RCTs were finally included.The effective rate of intratympanic combined with systemic glucocoticoid use and systemic glucocoticoid use for treating SHL were 72.70%and 51.70%respectively[OR=2.79,95%CI(2.17,3.58),P<0.01].Their cure rates were 26.45%and 17.18%respectively,the difference was statistically significant[OR=1.85,95%CI(1.24,2.78),P<0.01].The improvement value of average hearing threshold had statistically significant difference[MD=11.41,95%CI(8.40,14.42),P<0.01].Conclusion Intratympanic combined with systemic glucocoticoid use has better effect than simple systemic glucocoticoid use for treating SHL,but whether which may serve as the first choice of SHL treatment needs more clinical trials for further study.

关 键 词：听觉丧失 突发性 糖皮质激素 鼓室注射 META分析 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]