早期鼓室注射地塞米松与曲安奈德在全聋型突发性耳聋疗效探讨  

Early Intra-Tympanic Injection of Dexamethasone and Triamcinolone Acetonide for Treatment of Sudden Total Deafness

作　　者：顾翔 熊颖[1] 贺海霞 江梦贤 张琼 陈伟[1] GU Xiang;XIONG Ying;HE Haixia;JIANG Mengxian;ZAHNG Qiong;CHEN Wei(Department of Otolaryngology,Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院耳鼻咽喉头颈外科,武汉430000

出　　处：《中华耳科学杂志》2024年第3期353-357,共5页Chinese Journal of Otology

基　　金：武汉市卫健委基金项目(WX21Q51)。

摘　　要：目的 比较早期鼓室注射地塞米松磷酸钠与曲安奈德治疗全聋型突发性耳聋的临床疗效。方法 回顾性选取2020年1月至2022年1月华中科技大学同济医学院附属武汉市中心医院收治的80例全聋型突发性耳聋患者,根据治疗方法分为观察组40例和对照组40例。两组均进行改善微循环、营养神经、溶栓等基础治疗,对照组给予耳内镜下鼓室注射地塞米松,观察组给予耳内镜下鼓室注射曲安奈德,比较两组临床疗效、伴随症状改善率、不同频率下听阈差值改变。结果 观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组与对照组耳鸣、眩晕、耳闷等症状改善率比较,差异均无统计学意义(P>0.05);两组各频率平均听阈均有改善,中低频听力改善更明显,观察组500、1000、2000 Hz听阈差值均高于对照组,差异有统计学意义(P<0.001)。结论 全身治疗结合早期鼓室注射曲安奈德可提高全聋型突发性耳聋的治疗效果,临床上具有一定的推广价值。Objective To report outcomes of early intratympanic injection of dexamethasone sodium phosphate and triamcinolone acetonide in the treatment of total sudden sensorineural hearing loss(SNHL).Methods A total of 80eligible cases admitted to the Department of Otolaryngology,Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to January 2022 were retrospective reviewed.These cases were divided into a study group and a control group(40 each) based on their treatment.In addition to routine treatments including pro-microcirculation agents,neurotropic agents and thrombolysis agents,cases in the control group received endoscopic intratympanic injection of dexamethasone,while those in the study group received 4 doses of intratympanic injection of triamcinolone acetonide.Overall efficacy,improvement of accompanying symptoms,and changes in hearing were compared between the two groups.Results The rate of overall effectiveness in the study group was higher than that in the control group(P<0.05).There was no significant difference in improvement of tinnitus,vertigo and ear fullness(P>0.05).Both groups demonstrated improvement in average hearing threshold at all frequencies,with more noticeable improvements observed in middle and low frequencies.The improvement at 500,1000,and 2000 Hz in the study group was significantly greater than that in the control group(P<0.001).Conclusion Systemic therapy combined with early intratympanic injection of triamcinolone acetonide can improve outcomes in sudden SNHL,and may be worth of clinical adoption.

关 键 词：突发性耳聋 鼓室注射 地塞米松 曲安奈德 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]