摘要
目的:探讨高压氧辅鼓室和耳后助局部注射甲泼尼龙琥珀酸钠(Methylprednisolone sodium succinate,MPSS)治疗重度突发性耳聋(Sudden deafness,SD)患者的疗效,及对患者听力改善、血液流变学、凝血功能、血管内皮功能的影响。方法:选取2018年3月至2020年10月于我院就诊的248例重度SD患者作为研究对象进行回顾性分析,根据治疗方案不同,分为MPSS组和高压氧组,各124例。MPSS组在鼓室和耳后骨膜下采取MPSS局部治疗,高压氧组在MPSS组的基础上采用高压氧辅助治疗。治疗10 d后,比较两组疗效、听力改善情况、凝血功能、血液流变学、血管内皮功能、不良反应。结果:治疗后,高压氧组总有效率明显高于MPSS组,各频段听力强度明显高于MPSS组(P<0.05);高压氧组纤维蛋白原、血浆黏度、全血黏度、血清同型半胱氨酸(Homocysteine,Hcy)、内皮素水平均低于MPSS组,凝血酶时间(Thrombin time,TT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、凝血酶原时间(Prothrombin time,PT)、血清一氧化氮(Nitric oxid,NO)水平高于MPSS组(P<0.05);两组不良反应率无明显差异(P<0.05)。结论:高压氧辅助鼓室和耳后局部注射MPSS治疗重度SD患者的疗效显著,能有效改善机体的凝血功能和血液流变学,提升患者听力水平,且具有较高的安全性。
Objective:To investigate the effect of hyperbaric oxygen assisted tympanum and postauricular local injection of methylprednisolone sodium succinate(MPSS)in the treatment of severe sudden deafness(SD),and its effects on hearing improvement,hemorheology,blood coagulation and vascular endothelial function.Methods:A total of 248 patients with severe SD who visited our hospital from March 2018 to October 2020 were selected for retrospective analysis.According to different treatment plans,they were divided into MPSS group and hyperbaric oxygen group,with 124 patients in each group.On the basis of routine treatment,the MPSS group was treated locally in the tympanic cavity and under the periosteum behind the ear,and the hyperbaric oxygen group was treated with hyperbaric oxygen as an auxiliary treatment on the basis of the MPSS group.After 10 days of treatment,the curative effect,hearing improvement,coagulation function,hemorheology,vascular endothelial function and adverse reactions were compared between the two groups.Results:After treatment,the total effective rate of hyperbaric oxygen group was significantly higher than that of MPSS group,and the hearing intensity of each frequency band was significantly higher than that of MPSS group(P<0.05).The fibrinogen,plasma viscosity,whole blood viscosity,serum homocysteine(Hcy)and endothelin water in hyperbaric oxygen group were lower than those in MPSS group,while the levels of thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT)and serum nitric oxide(NO)in MPSS group were higher than those in MPSS group(P<0.05).The adverse reaction rate had no significant difference between the two groups(P<0.05).Conclusion:Hyperbaric oxygen assisted tympanic and retroauricular local injection of MPSS is effective in the treatment of severe SD patients.It can effectively improve the coagulation function and hemorheology of the body,improve the hearing level of patients,and has high safety.
作者
邓艳娜
马铜邦
李靖
Deng Yan-na;Ma Tong-bang;Li Jing(Department of Otolaryngology,Neihuang People's Hospital,Anyang 456300,Henan,China;The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,Henan,China)
出处
《四川生理科学杂志》
2023年第8期1356-1359,1387,共5页
Sichuan Journal of Physiological Sciences
关键词
甲泼尼龙琥珀酸钠
高压氧
突发性耳聋
凝血功能
Methylprednisolone sodium succinate
Hyperbaric oxygen
Sudden deafness
Coagulation function
