摘要
目的:观察鼓室内注射地塞米松或甲泼尼龙治疗突发性聋的疗效。方法:鼓膜穿刺注入地塞米松(5 g/L)或甲泼尼龙(40 g/L),每日注射1次,7 d为1个疗程。比较地塞米松和甲泼尼龙鼓室内注射前后4个频率(500、1 000、2 000、4 000 Hz)气导纯音听阈均值(PTA),下降10 dB以上为有效。结果:47例突发性聋患者中,鼓室内注射地塞米松组(24例)前后PTA分别为(71.59±27.66)dB HL、(53.44±30.10)dB HL,经配对t检验差异有统计学意义(P<0.01),总有效率为67%。鼓室内注射甲泼尼龙组(23例)前后的PTA分别为(68.64±25.21)dB HL、(55.76±26.42)dB HL,经检验差异有统计学意义(P<0.01),总有效率为43%。经Fisher Exact检验,鼓室内注射地塞米松组和甲泼尼龙组的有效率差异无统计学意义(P>0.05)。11例患者经过其他治疗(静脉类固醇药物、扩血管药物或高压氧治疗)后再应用鼓室内注射地塞米松治疗,仍然取得了较好的疗效(P<0.05);13例患者单纯应用鼓室内注射地塞米松治疗,PTA下降较明显,差异有统计学意义(P<0.05)。17例患者经过其他治疗再应用鼓室内注射甲泼尼龙治疗,仍然取得了较好的疗效(P<0.01),6例患者单纯应用鼓室内注射甲泼尼龙治疗,PTA虽有下降,但差异无统计学意义(P>0.05)。患者未出现鼓室内感染、鼓膜穿孔和听力下降。结论:鼓室内注射地塞米松或甲泼尼龙治疗突发性聋有效,两者之间的疗效比较无明显差异。推荐地塞米松作为鼓室内注射药物治疗突发性聋,并作为突发性聋的初始治疗。
Objective：To investigate the effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss.Method：Forty-seven subjects received an at least 7-day dexamethasone（5 g/L/d） or methylprednisolone（40 g/L/d） course.Pure-tone averages（PTA） of pre-injection and post-injection at 4-frequency（500、1000、2000、4000 Hz） were compared.More than 10 dB HL of improvement in PTA was considered to be clinically significant.Result：PTA of pre-injection and post-injection were（71.59±27.66）dB HL and（53.44±30.10）dB HL respectively in 24 patients with intratympanic dexamethasone.There was significant improvement in PTA（P0.01）,1.67% of patients showed improvement in hearing.PTA of pre-injection and post-injection were（68.64±25.21）dB HL and（55.76±26.42）dB HL respectively in 23 patients with intratympanic methylprednisolone.There was significant improvement in PTA（P0.01）,43% of patients showed improvement in hearing.There was no significant difference in PTA between intratympanic dexamethasone and methylprednisolone.After dexamethasone injection,evident improvement was accomplished in 11 cases who underwent treatment with other therapy（systemic steroids,vasodilator agent,or high-pressure-oxygen therapy）（P0.05）;PTA showed significant improvement in 13 cases with only intratympanic dexamethasone（P0.05）.After methylprednisolone injection,evident improvement was accomplished in 17 cases who underwent treatment with other therapy（P0.01）;PTA decreased but had no significance in 6 cases with only intratympanic methyl-prednisolone（P0.05）.No unexpected adverse events such as otitis media,perforated tympanic membrane and worsening in hearing occurred during the injection or follow-up period.Conclusion：Intratympanic dexamethasone or methylprednisolone can be beneficial in treatment on patient with sudden sensorineural hearing loss,however,there was no significant difference in the effect between dexamethasone and methylprednisolone.Dexamethasone is recommended to use as favorable drug for intratympanic application that could be primary therapy in treatment on sudden sensorineural hearing loss.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第13期594-597,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
上海市科委资助课题(No:034119819)
"十一五"国家科技支撑计划-前庭中枢代偿机制及眩晕疾病规范化诊断与康复治疗方案研究(No:2007BAI18B13)
关键词
鼓室内注射
地塞米松
甲泼尼龙
突发性聋
气导纯音听阈均值
intratympanic
dexamethasone
methylprednisolone
sudden sensorineural hearing loss
pure-tone averages
