鼓室内注射地塞米松治疗伴眩晕的全聋型突发性聋的疗效分析  

Therapeutic effect of intra-tympanic injection of dexamethasone on patients with profound idiopathic sudden sensorineural hearing loss accompanied by vertigo

作　　者：张志坚[1] 祝园平 杨希林[1] 朱明万[1] 肖伯奎[1] 廖华[1] 江洋[1] 华清泉[1] Zhang Zhijian;Zhu Yuanping;Yang Xilin;Zhu Mingwan;Xiao Bokui;Liao Hua;Jiang Yang;Hua Qingquan(Department of Otolaryngology&Head and Neck Surgery,Renmin Hospital of Wuhan University,Wuhan,430060,China)

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,武汉430060

出　　处：《听力学及言语疾病杂志》2018年第6期612-615,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金面上项目(81271073);教育部留学回国基金(302-153775)资助

摘　　要：目的探讨鼓室内注射地塞米松治疗伴眩晕的全聋型突发性聋的可行性及疗效。方法回顾性分析38例(38耳)伴眩晕的全聋型突聋患者的临床资料,将38例(38耳)伴眩晕的全聋型突聋患者分为两组,鼓室注射组30例(30耳),给予鼓室内注射地塞米松0.3ml,每日一次或隔2～3天一次,疗程14.76±7.33天,其中注射3～5次4例,6～10次15例,11～28次11例;对照组8例(8耳),给与静脉注射地塞米松10mg/天,3天后减半,疗程10.25±2.55天;两组患者均同时接受改善耳蜗微循环、营养神经等常规全身用药,比较两组疗效并分析鼓室注射组注药次数与疗效的关系。结果治疗后,鼓室注射组0.25～8kHz气导纯音听阈平均值由101.73±12.19dB HL下降为84.80±20.87dB HL,对照组由115.50±4.38dB HL降为109.25±16.57dB HL。鼓室注射组治疗后痊愈0例,显效6例,有效12例,无效12例,总有效率为60.00%(18/30);对照组患者治疗后痊愈0例,显效1例,有效0例,无效7例,总有效率为12.50%(1/8)。鼓室注射组患者疗效与鼓室内注药次数正相关,注药次数越多,疗效越好,注药次数超过10次组的总有效率可高达81.82%(P<0.05)。结论鼓室内注射地塞米松是治疗伴眩晕的全聋型突聋的有效方法,且注药次数越多,疗效越好。Objective To investigate the therapeutic effect of intra-tympanic injection of dexamethasone on patients with profound idiopathic sudden sensorineural hearing loss accompanied by vertigo.Methods The clinical data of 38 cases(38 ears)with profound idiopathic sudden sensorineural hearing loss accompanied by vertigo were retrospectively analyzed.These 38 cases(38 ears)were divided into two groups:the intra-tympanic injection group(30 cases 30 ears;received intra-tympanic injection of dexamethasone;250~8 000 Hz average hearing threshold was 101.73±12.19 dB HL)and control group(8 cases 8 ears;received intravenous injection of dexamethasone;250~8 000 Hz average hearing threshold was 115.50±4.38 dB HL).Both groups also received conventional systemic medications such as improving cochlear microcirculation and neurotrophic treatment.The therapeutic effects of the two groups were compared and the relationship between the frequency of intra-tympanic injection and the efficacy in the intra-tympanic injection group was analyzed.Results The post treatment hearing thresholds were 84.80±20.87 dB HL in the intra-tympanic injection group and 109.25±16.57 dB HL in the control group,respectively.The total efficacy rate was 60.00%in the intra-tympanic injection group,which was significantly better than that of 12.50%in the control group.In the intra-tympanic injection group,the therapeutic effect was positively correlated with the frequency of intra-tympanic injection,the more frequent intra-tympanic injection,the better curative effect(P<0.05).Conclusion Intra-tympanic injection of dexamethasone is an effective method for the treatment of profound idiopathic sudden sensorineural hearing loss with vertigo,the more frequent intra-tympanic injection,the better therapeutic effect.

关 键 词：全聋型突发性聋 眩晕 糖皮质激素 鼓室内注药 疗效 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]