耳后注射倍他米松联合鼠神经生长因子治疗突发性耳聋的疗效观察  

Observation on the therapeutic effect of betamethasone combined with nerve growth factor on sudden deafness

作　　者：左建峰 钱茂华 沈倪美 赵真 Zuo Jianfeng;Qian Maohua;Shen Nimei;Zhao Zhen(Department of Otolaryngology,Head and Neck Surgery,Second Affiliated Hospital of Nantong University/Nantong First People’s Hospital,Jiangsu Nantong 226006,China;Department of Otolaryngology,Head and Neck Surgery,Nanjing Hospital Affiliated to Nanjing Medical University,Jiangsu Nanjing 210008,China)

机构地区：[1]南通大学第二附属医院/南通市第一人民医院耳鼻咽喉头颈外科,江苏南通226006 [2]南京医科大学附属南京医院耳鼻咽喉头颈外科,江苏南京210008

出　　处：《中国医刊》2023年第5期530-533,共4页Chinese Journal of Medicine

基　　金：2021年度南京市卫生科技发展专项资金项目(宁卫财务[2021]67号第20)。

摘　　要：目的探讨耳后筛区骨膜下注射倍他米松联合鼠神经生长因子治疗突发性耳聋(sudden deafness,SD)的临床疗效。方法选取2019年7月至2021年12月南通大学第二附属医院/南通市第一人民医院收治的80例SD患者,采用随机数字表法分为对照组和观察组,每组40例。两组均给予常规基础治疗及倍他米松+鼠神经生长因子注射治疗,对照组采用肌内注射,观察组采用耳后筛区骨膜下注射。比较两组治疗前后的纯音听阈值变化,听力、耳鸣症状、耳闷胀感改善情况,以及治疗期间的不良反应发生情况。结果观察组在250、500、1000、2000Hz下测得的平均听力提高值均明显高于对照组,差异有显著性(P<0.05),而两组在4000、8000Hz下测得的平均听力提高值比较差异无显著性(P>0.05)。观察组的听力改善总有效率(82.50%)、耳鸣症状改善总有效率(69.70%)及耳闷胀感改善有效率(83.33%)均明显高于对照组(分别为62.50%、50.00%、60.87%),差异有显著性(P<0.05)。治疗期间观察组的不良反应发生率(5.00%)与对照组(7.50%)比较差异无显著性(P>0.05)。结论耳后筛区骨膜下注射倍他米松及鼠神经生长因子治疗SD可有效提高患者听力水平,尤其对中低频听力改善作用显著,并可减轻耳鸣、耳闷胀感,疗效较好且无明显不良反应。Objective To investigate the clinical efficacy of posterior ear injection of betamethasone combined with rat nerve growth factor in the treatment of sudden deafness(SD).Method Eighty cases of SD patients admitted in the Second Affiliated Hospital of Nantong University/Nantong First People’s Hospital from July 2019 to December 2021 were selected and randomly divided into two groups(40 cases each).The control group was given routine basic treatment,and the observation group was given postauricular injection(betamethasone+rat nerve growth factor)on the basis of the control group.The changes of pure tone hearing threshold,hearing effect,ear stuffiness and tinnitus symptoms before and after treatment were compared between the two groups.Result The average hearing improvement values measured at 250Hz,500Hz,1000Hz and 2000Hz in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference between the two groups in the average hearing improvement values measured at 4000Hz and 8000Hz(P>0.05).The total effective rate of hearing improvement(82.50%vs 62.50%),the total effective rate of tinnitus(69.70%vs 50.00%)and the effective rate of ear stuffiness(83.33%vs 60.87%)in the observation group were significantly higher than those in the control group(P<0.05).The score of quality of life after treatment in both groups was significantly higher than that before treatment,and the score of quality of life after treatment in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Postauricular injection of betamethasone combined with rat nerve growth factor can effectively improve the hearing level of SD patients,especially in the middle and low frequency hearing,and help to reduce the symptoms of tinnitus and ear stuffiness,with significant efficacy and no obvious adverse reactions.

关 键 词：突发性耳聋 鼠神经生长因子 倍他米松 耳鸣 耳闷胀感 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]