鼓室注射甲泼尼龙琥珀酸钠联合全身性糖皮质激素疗法治疗重度突发性聋的疗效观察  

Therapeutic effect of intratympanic methylprednisolone injection combined with systemic glucocorticoid therapy on severe sudden deafness

作　　者：李莉[1] 安丽[1] 拓明祥 乔治强[1] LI Li;AN Li;TUO Mingxiang;QIAO Zhiqiang(Department of Otolaryngology Head and Neck Surgery, Yan'an People's Hospital, Yan'an, Shanxi, 716000, China)

机构地区：[1]延安市人民医院耳鼻咽喉头颈外科

出　　处：《中国耳鼻咽喉头颈外科》2019年第6期306-309,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨鼓室注射甲泼尼龙琥珀酸钠联合全身性糖皮质激素疗法治疗重度突发性聋疗效。方法选取2016年6月~2018年6月重度突发性聋患者120例,随机分为鼓室注射组和全身用药组,每组60例,全身用药组给予全身性糖皮质激素疗法,鼓室注射组在此基础上给予鼓室注射甲泼尼龙琥珀酸钠疗法。结果鼓室注射组治疗后肿瘤坏死因子-α、白细胞介素6、高敏C反应蛋白和治疗5、10天后纯音听力阈值明显低于全身用药组,鼓室注射组治疗前、后肿瘤坏死因子-α、白细胞介素6、高敏C反应蛋白和纯音听力阈值变化值明显高于全身用药组,鼓室注射组治疗有效率为96.67%,明显高于全身用药组的86.67%,有统计学差异(χ^2=3.927,P=0.048);鼓室注射组和全身用药组不良反应率比较,无统计学差异(P>0.05)。结论鼓室注射甲泼尼龙琥珀酸钠联合全身性糖皮质激素疗法可改善重度突发性聋患者炎症状态和纯音听力阈值,提高治疗疗效,且安全性好。OBJECTIVE To discuss the therapeutic effect of intratympanic injection of methylprednisolone sodium succinate combined with systemic glucocorticoid therapy(SGT) on severe sudden deafness(SD). METHODS 120 patients with severe SD were selected from June 2016 to June 2018, they were randomly divided into tympanic group and single group, 60 cases in each group. The single group was given SGT, and the tympanic group was given methylprednisolone sodium succinate through intratympanic injection. RESULTS The value of tumor necrosis factor-α(TNF-α), interleukin 6(IL-6), high sensitive C reactive protein(hs-CRP) and 5 and 10 d pure tone hearing threshold(PTHT) after treatment in tympanic group were significantly lower than those in single group, the changes of TNF-α, IL-6, hs-CRP and PTHT after treatment in the tympanic group were significantly higher than those in single group, the effective rate in tympanic group was 96.67%, it was significantly higher than the 86.67% in single group, the difference was statistically significant(χ^2=3.927, P<0.05). When compare the adverse reaction rate between the tympanic group and single group, the difference was not statistically significant(P>0.05). CONCLUSION Methylprednisolone sodium succinate for injection intratympanic injection combined with SGT can effectively improve the inflammation and PTHT in patients with severe SD, which is conducive to improving therapeutic efficacy, and the safety was assured.

关 键 词：听力丧失 突发性 糖皮质激素类 临床方案 鼓室注射 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]