耳后骨膜下注射甲强龙联合纤溶酶治疗突发性耳聋的效果  

Therapeutic effect of postauricular subperiosteal injection of methylprednisolone combined with plasmin on sudden deafness

作　　者：张文静[1] 张根养 Zhang Wenjing;Zhang Genyang(Department of Otology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Otolaryngology,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]郑州大学第一附属医院耳科,郑州450000 [2]陕西中医药大学附属医院耳鼻咽喉科,咸阳712000

出　　处：《中国实用医刊》2024年第18期78-81,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析耳后骨膜下注射甲强龙联合纤溶酶对突发性耳聋(SD)的效果。方法队列研究。抽取2022年4月至2024年4月郑州大学第一附属医院收治的82例SD患者,按照随机数字表法分成对照组和观察组,每组41例。对照组行耳后骨膜下注射甲强龙治疗,观察组在对照组治疗基础上加以纤溶酶治疗。比较两组临床疗效、生化指标[同型半胱氨酸(Hcy)、一氧化氮(NO)]、血流动力学[全血高切黏度、全血低切黏度、红细胞压积(HCT)]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]及不良反应发生情况。结果观察组治疗总有效率(95.12%,39/41)高于对照组(80.49%,33/41),P<0.05。治疗后,观察组Hcy水平[(13.41±2.02)μmol/L]低于对照组[(20.25±2.97)μmol/L],NO水平[(53.59±8.26)μmol/L]高于对照组[(47.46±6.91)μmol/L],P<0.05。治疗后,观察组全血高切黏度、全血低切黏度、HCT均低于对照组(P均<0.05)。治疗后,观察组APTT、TT及PT均长于对照组(P均<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论耳后骨膜下注射甲强龙联合纤溶酶可有效提高SD患者听力,改善局部血液高凝状态,调节耳蜗微循环,且无严重不良反应。Objective To analyze the effect of postauricular subperiosteal injection of methylprednisolone combined with plasmin in the treatment of sudden deafness(SD).Methods Eighty-two SD patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2022 to April 2024 were selected for the cohort study,and they were divided into the control group and the observation group according to the random number table method,with 41 cases in each group.The control group was treated by postauricular subperiosteal injection of methylprednisolone,while the observation group received plasmin treatment based on the therapy of the control group.The clinical efficacy,biochemical indicators including homocysteine(Hcy)and nitric oxide(NO),hemodynamics evaluated by whole blood high shear viscosity,whole blood low shear viscosity and hematocrit(HCT),coagulation function assessed by activated partial thromboplastin time(APTT),thrombin time(TT)and prothrombin time(PT),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 95.12%(39/41),which was higher than the 80.49%(33/41)of the control group(P<0.05).After treatment,the Hcy level in the observation group was(13.41±2.02)μmol/L,lower than the(20.25±2.97)μmol/L in the control group(P<0.05);while the NO level in the observation group was(53.59±8.26)μmol/L,higher than the(47.46±6.91)μmol/L in the control group(P<0.05).After treatment,the observation group had lower whole blood high shear viscosity,lower whole blood low shear viscosity,and lower HCT than the control group(all P<0.05).After treatment,the APTT,TT,and PT in the observation group were longer than those in the control group(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Postauricular subperiosteal injection of methylprednisolone combined with plasmin can effectively improve hearing in SD patients,improve local blood hypercoagulabe st

关 键 词：耳聋 突发性 甲强龙 纤溶酶 血流动力学 不良反应 一氧化氮 红细胞压积 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]