局部联合系统激素疗法治疗突发性感觉神经性耳聋的疗效  

作　　者：胡燕萍[1] 李勇[2] 曹晓林[2] 倪海峰[2] 

机构地区：[1]杭州市肿瘤医院,310005 [2]杭州市第一人民医院,310003

出　　处：《浙江临床医学》2023年第5期683-685,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2021KY870)。

摘　　要：目的探讨局部联合系统激素治疗突发性感觉神经性耳聋的疗效。方法选择2021年5月至2022年6月特发性、突发性感觉神经性耳聋患者126例。按照随机数字表法分为观察组和对照组,每组63例。观察组采用联合治疗(鼓室内注射甲泼尼龙+口服类固醇药物),对照组给予口服类固醇药物单独治疗。比较两组临床疗效,并分析影响治疗效果的相关因素。结果观察组与对照组整体听力改善率分别为90.5%、61.9%,组间差异有统计学意义(P=0.036)。第2周和第4周观察组纯音听阈均值(PTA)改善及语音辨别分数(SDS)评分均优于对照组(P<0.05)。对于重度听力损害患者,观察组PTA及SDS评分改善更显著(P<0.05),观察组在低中高三种频率方面改善优于对照组(P<0.05)。治疗前的症状持续时间和初始PTA水平可对治疗结果产生影响(P<0.05)。结论突发性感觉神经性耳聋患者联合鼓室内局部与系统激素疗法具有显著的优势,建议作为初始治疗方案,尤其是对重度听力损害的患者。Objective To explore the difference in the clinical efficacy of combined topical and systemic hormone therapy in the treatment of sudden deafness compared with systemic hormone therapy alone.Methods The study period was from May 2021 to June 2022.A total of 126 patients with idiopathic and sudden sensorineural hearing loss who visited our hospital during this period were included in the study.According to the random number table method,the subjects were divided into the study group and the control group,with 63 cases respectively.Combination therapy(intratympanic injection of methylprednisolone+oral steroids)was used in the study group,while oral steroids were administered alone in the control group.The clinical efficacy differences between groups were compared,and the related factors affecting the treatment efficacy were analyzed.Results The overall hearing improvement rates of the study group and the control group were 90.5%and 61.9%,respectively,and the difference between the two groups was statistically significant(P=0.036).The PTA improvement and SDS score of the study group were significantly better than those of the control group in the 2nd and 4th week(P<0.05).For patients with severe hearing impairment,the improvement of PTA and SDS scores in the study group was more significant,with statistical significance(P<0.05).In addition,the improvement in the low,middle and high frequencies of the study group was significantly better than that of the control group,with statistical significance(P<0.05).The duration of symptoms before the treatment and initial PTA level had a significant effect on treatment outcome,with statistical significance(P<0.05).Conclusion The combination of intratympanic local and systemic hormone therapy in patients with sudden deafness has significant advantages,and it is recommended as an initial treatment plan,especially for patients with severe hearing impairment.

关 键 词：突发性感觉神经性耳聋 激素治疗 局部治疗 系统治疗 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]