不同部位局部注射糖皮质激素治疗突发性聋的Meta分析  

Local injections of glucocorticoids at different regions in the treatment of sudden sensorineural hearing loss:a Meta-analysis

作　　者：陈天玮 朱昊远 倪佳豪 蒋龙魁[2] 戴建国[3] Chen Tianwei;Zhu Haoyuan;Ni Jiahao;Jiang Longkui;Dai Jianguo(Major of Clinical Medicine,School of Medicine,Nanjing University of Chinese Medicine,Nanjing210023,China;Organization Department&United Front Work Department,Nanjing University of Chinese Medicine,Nanjing210023,China;Department of Pathology and Pathophysiology,School of Medicine,Nanjing University of Chinese Medicine,Nanjing210023,China)

机构地区：[1]南京中医药大学医学院临床医学专业,南京210023 [2]南京中医药大学组织部及统战部,南京210023 [3]南京中医药大学医学院病理学与病理生理学系,南京210023

出　　处：《中华耳鼻咽喉头颈外科杂志》2025年第1期10-21,共12页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的分析比较耳后注射及鼓室注射糖皮质激素初始治疗突发性聋的疗效和安全性。方法检索PubMed、Web of Science、中国知网(CNKI)、维普(VIP)、万方数据(WANFANG)等数据库,收集2015—2024年间发表的有关糖皮质激素耳后注射及鼓室注射初始治疗突发性聋的随机对照研究,采用RevMan5.4对符合纳入标准的文献进行分析,探讨糖皮质激素不同局部给药方式治疗突发性聋的效果和安全性。结果共检索获得文献971篇,经筛选纳入23篇中文文献。Meta分析发现耳后注射总有效率明显高于鼓室注射(OR=1.37,95%CI:1.15~1.65,P=0.0006);耳后注射患者听阈恢复值高于鼓室注射(SMD=1.24,95%CI:0.01~2.46,P=0.05);鼓室注射的不良反应及并发症发生率明显高于耳后注射(OR=0.20,95%CI:0.15~0.28,P<0.00001)。结论突发性聋患者耳后注射糖皮质激素比鼓室注射糖皮质激素疗效更好、安全性更高,但仍需进一步明确何种局部给药方式可作为突发性聋的首选初始治疗方案。Objective To compare the efficacy and safety of postauricular injection(PI)and intratympanic injection(II)of glucocorticoids(GC)in the initial treatment of sudden sensorineural hearing loss(SHL).Methods Electronic databases retrieval(PubMed,Web of Science,CNKI,VIP,WANFANG)was performed to identify all randomized controlled trials about PI and II of GC in the initial treatment of SHL between 2015 and 2024.Meta-analysis was performed on the studies met the inclusion criteria by RevMan5.4.Results A total of 971 articles were retrieved,and 23 Chinese articles were included after screening.Meta-analysis found that the total effective rate of PI was significantly higher than that of II(OR=1.37,95%CI:1.15-1.65,P=0.0006),with higher recovery of the hearing threshold(SMD=1.24,95%CI:0.01-2.46,P=0.05)and a lower incidence of adverse reactions and complications(OR=0.20,95%CI:0.15-0.28,P<0.00001).Conclusions Compared with II,PI has a better efficacy and safety.Nonetheless,whatever topical administration of GC that can be regarded as the first choice of initial therapeutic schedules to SHL requires further studied.

关 键 词：听觉丧失 突发性 糖皮质激素类 META分析 耳后注射 鼓室注射 投药途径 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]