鼓室内注射地塞米松联合高压氧治疗在难治性高频下降型突发性聋的效果分析  

Effect of intratympanic injection of dexamethasone combined with hyperbaric oxygen in the treatment of refractory high-frequency descending sudden deafness

作　　者：乔冰[1] 芦二永[1] 张超[1] 张慧[2] QIAO Bing;LU Eryong;ZHANG Chao;ZHANG Hui(Department of ENT,The First Affiliated Hospital of Henan University of science and technology,Luoyang Henan 471003,China;Department of ENT,The Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]河南科技大学第一附属医院耳鼻喉科,河南洛阳471003 [2]郑州大学第二附属医院耳鼻喉科,河南郑州450000

出　　处：《临床研究》2021年第12期31-33,37,共4页Clinical Research

摘　　要：目的探讨鼓室内注射地塞米松常规西药和高压氧应用于在难治性高频下降型突发性聋患者中的效果以及安全性。方法选取2018年3月至2020年12月河南科技大学第一附属医院难治性高频下降型的突发性聋81例患者,按照随机数字表法进一步将81例患者分为对照组(n=40)和研究组(n=41)。其中对照组给予鼓室内注射地塞米松治疗,研究组在对照组的基础上进一步给予患者高压氧治疗。对比分析两组的疗效、血液流变学指标[纤维蛋白原(FIB)水平、红细胞聚集指数(RE)]以及对血清内皮素(ET)、可溶性血管细胞黏附分子-1(sVCAM-1)、抗内皮细胞抗体(AECA)水平的影响和不良反应。结果研究组的治疗有效率92.68%明显高于对照组75.00%(P<0.05);两组治疗14 d后FIB、RE均低于治疗前,且研究组低于对照组(P<0.05);治疗前,两组患者血清ET、sVCAM-1、AECA水平比较差异无统计学意义(P>0.05),治疗14 d后,研究组患者血清ET、sVCAM-1、AECA水平较治疗前均降低(P<0.05),且研究组治疗前后血清ET、sVCAM-1、AECA水平差值均高于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(12.50%VS9.76%)(P>0.05)。结论针对难治性高频下降型突发性聋患者,采用鼓室内注射地塞米松和高压氧联合进行治疗效果显著,不仅可改善血液流变学指标,而且安全性较高。Objective To discuss the efficacy and safety of conventional dexamethasone western medicine and hyperbaric oxygen in patients with refractory high-frequency descending sudden deafness.Methods A total of 81 patients with sudden deafness with refractory high-frequency decline from March 2018 to December 2020 were selected,and 81 patients were further divided into control groups(n=40)and study groups(n=41)according to the randomized digital table method.The control group was given tympanic dexamethasone,and the study group further gave patients hyperbaric oxygen therapy based on the control group.The curative effects,hemorheological indexes[FIB level,erythrocyte aggregation index(RE)]and serum endothelin of the two groups were compared and analyzed Results The total effective rate of the study group was 92.68%higher than 75.00%of the control group(P<0.05);FIB and re in the two groups were lower than those before treatment,and the study group was lower than that in the control group(P<0.05);before treatment,there was no significant difference in the levels of serum ET,sVCAM-1 and AECA between the two groups(P>0.05).After 14 days of treatment,the levels of serum ET,sVCAM-1 and AECA in the study group were lower than those before treatment(P<0.05),and the differences of serum ET,sVCAM-1 and AECA levels in the study group before and after treatment were higher than those in the control group(P<0.05);There was no significant difference between the two adverse reaction groups(12.50%VS 9.76%)(P>0.05).Conclusion For patients with refractory high-frequency descending sudden deafness,the combination of dexamethasone and hyperbaric oxygen has a significant treatment effect,which can not only improve the blood rheological indicators,but also have high safety and is worthy of clinical promotion and application.

关 键 词：地塞米松 高压氧 难治性高频下降型突发性聋 效果 高峰听力 

分 类 号：R856.76[医药卫生—航空、航天与航海医学]