摘要
目的鼓室内灌注地塞米松治疗已逐渐应用于突发性耳聋经全身性治疗后无效的患者。本研究对鼓室内灌注地塞米松作为重度、极重度突发性聋的补救治疗的有效性进行评估。方法回顾2007年1月至2009年12月的重度、极重度突聋病例,经全身性治疗后采取鼓室灌注地塞米松的方法治疗14天。采用Sigel标准进行评判,将患者完全或部分恢复听力认作成功治愈。比较重度突聋组和极重度突聋组的治疗效果。结果与极重度突聋组相比,所有重度突聋组患者经治疗后听力均明显提高(P=0.017)。经最初的全身治疗后,重度突聋组的治愈率为36%(9/25),极重度突聋组的治愈率为18.1%(4/22)(P=0.207)。与之相比,鼓室内应用地塞米松作为补救治疗在重度突聋组的治愈率为37.5%(6/16),极重度突聋组为5.5%(1/18)(P=0.03)。结论与重度突聋组相比,我们不认为鼓室内灌注地塞米松作为极重度突聋患者的补救治疗有效。建议应事先告知极重度突聋患者此种补救治疗的方法可能疗效欠佳。
Objective Intratympanic dexamethasone perfusion is being increasingly used in the treatment of sudden hearing loss （SHL） after the failure of systemic therapy. This study evaluated the efficacy of administering intratympanic dexamethasone （ITD） as the salvage treatment for severe and profound SHL. Methods We reviewed the medical records of patients who presented with severe and profound SHL from January 2007 to December 2009. ITD was given about 14 days after the initial systemic treatment. Successful recovery was defined as complete or partial recovery using Sigel＇s criteria. We compared the results of treatment between the severe SHL （S-SHL） and profound SHL （P-SHL） groups. Results All the patients in the S-SHL group showed significant improvement, as compared to the P-SHL group （P = 0.017）. The recovery rate after the initial systemic treatment was 36% （9/25） in the S-SHL group and 18.1% （4/22） in the P-SHL group （P = 0.207）. In comparison, the recovery rate of ITD as the salvage treatment was 37.5% （6/16） in the S-SHL group and 5.5% （1/18） in the P-SHL group （P = 0.03）. Conclusion Our comparative study dose not support the efficacy of ITD as the salvage treatment for patients with P-SHL as compared with that for S-SHL. We recommend that the patients with P-SHL shall be informed about the low efficacy of ITD as the salvage treatment.
出处
《临床医学工程》
2011年第10期1533-1535,共3页
Clinical Medicine & Engineering
关键词
鼓室内
地塞米松
突发性聋
Intratympanic
Dexamethasone
Sudden hearing loss
