鼓室注射药物治疗急性难治性耳鸣的疗效观察  

Observation on the curative effect of drug injection in tympanum on acute refractory tinnitus

作　　者：牛艳 柳林整[1] 姜凤举 王慧涛 李艳[1] 彭裕萍 申江江 常小慧 白芳芳 NIU Yan;LIU Lin-zheng;JIANG Feng-jv;WANG Hui-tao;LI Yan;PENG Yu-ping;SHEN Jiang-jiang;CHANG Xiao-hui;BAI Fang-fang(Department of ENT,Yulin No.1 Hospital,Yulin 719000,China)

机构地区：[1]榆林市第一医院耳鼻咽喉头颈外科,陕西榆林719000

出　　处：《延安大学学报（医学科学版）》2020年第1期63-66,70,共5页Journal of Yan'an University:Medical Science Edition

基　　金：陕西省榆林市2016年度科技计划项目。

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急性难治主观特发性耳鸣的疗效。方法选择经常规全身用药治疗两周无效的急性难治主观特发性耳鸣患者41例41耳,随机分为治疗组和对照组,治疗组21例21耳,对照组20例20耳。治疗组鼓室注射甲泼尼龙琥珀酸钠0.2 mL和利多卡因注射液0.2 mL,对照组注射甲泼尼龙琥珀酸钠0.4 mL,2次/周,连续2周,共4次,根据耳鸣致残量表(THI)、耳鸣响度(VAS)和持续时间调查问卷及纯音听阈在治疗前后对41例患者进行随访。治疗3月后比较分析治愈率、有效率、耳鸣响度平均变化和THI值来评估两组的疗效。结果治疗3月后两组耳鸣响度平均变化和THI值均较治疗前下降,治疗组耳鸣响度由4.238±1.972下降至2.381±2.109,差异有统计学意义(P<0.001),THI值由46.8±19.707下降至28.476±22.318,差异有统计学意义(P<0.001);对照组耳鸣响度由4.7±1.559下降至3±2.176,差异有统计学意义(P=0.009),THI值由44.48±21.945下降至31.85±23.604,差异有统计学意义(P<0.001)。治疗组治愈率为28.6%,对照组治愈率为20%,差异无统计学意义(P=0.523);治疗组有效率为66.7%,对照组有效率为35%,差异有统计学意义(P<0.05)。结论鼓室注射糖皮质激素可作为急性特发性难治性主观性耳鸣患者的一种治疗方案,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 curative effect on treatment of refractory acute subjective idiopathic tinnitus by injecting methylprednisolone sodium succinate and injecting methylprednisolone sodium succinate&lidocaine into ear drum.Methods Forty-one patients(41 ears),treated ineffectively and diagnosed as refractory acute subjective idiopathic tinnitus after two weeks’systemic routine treatment,were selected and divided into two groups,with Treatment Group of 21 patients(ears)and Control Group of 20 patients(ears).Patients of the Treatment Group were injected with 0.2 mL methylprednisolone sodium succinate and 0.2 mL lidocaine;while patients of the Control Group were injected with 0.4 mL methylprednisolone sodium succinate.The injection was done twice a week for continuous 2 weeks,in total four times.The follow-up visit of the 41 patients has been arranged before and after the treatment respectively based on Tinnitus Handicap Inventory(THI),Visual Analog Scale(VAS),Questionnaire of Tinnitus Duration,and Pure-tone Audiogram.The curative effect was evaluated between the two groups based on the comparison and analysis of healing rate,effective rate,average change of tinnitus volume and THI after 3 months’treatment.Results The average change of tinnitus volume ad THI of the two groups have been reduced after 3 months’treatment.For the Treatment Group,the tinnitus volume is reduced from 4.238±1.972 to 2.381±2.109,which shows a statistic difference(P<0.001);and THI is reduced from 46.8±19.707 to 28.476±22.318,indicating the statistic difference(P<0.001).For the Control Group,the tinnitus volume is reduced from 4.7±1.559 to 3±2.176,which has a statistic difference(P=0.009);THI is reduced from 44.48±21.945 to 31.85±23.604,having a statistic difference(P<0.001).The healing ratios of Treatment Group and Control Group are 28.6%and 20%respectively,which has no statistic difference(P=0.523).The effective rate of Treatment Group and Control Group are 66.7%and 35%,which has a statistic difference(P<0.05).Conclusion In

关 键 词：耳鸣 急性 甲泼尼龙琥珀酸钠 利多卡因 鼓室注射 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]