摘要
目的探讨常规药物治疗效果不佳的难治性突发性聋患者在高压氧不耐受情况下鼓室注射糖皮质激素的临床疗效。方法经常规药物治疗十天以上效果不佳的突发性聋患者,按高压氧耐受与否,分为鼓室注射组28例(28耳)与高压氧组34例(34耳);鼓室注射组年龄31~81岁,平均52.54±10.90岁,鼓室内注射甲泼尼龙20mg,隔日一次,连续五次;高压氧组年龄41~68岁,平均54.09±8.24岁,每日行高压氧治疗一次,共10天;观察两组治疗前后的听阈变化及有效率。结果鼓室注射组治疗前0.25~8kHz平均听阈为65.54±18.17dB HL,治疗后平均听阈下降18.54±13.87dB,痊愈2例,显效5例,有效4例,无效17例,总有效11例(11耳),总有效率为39.29%(11/28);对照组治疗前平均听阈为67.21±18.36dB HL,治疗后平均听阈下降17.26±12.77dB,痊愈4例,显效5例,有效4例,无效21例,总有效13例(13耳),总有效率为38.24%(13/34),两组总有效率比较差异无统计学意义(P>0.05)。结论鼓室注射激素和高压氧治疗均可改善难治性突聋患者的听力,鼓室注射尤其适合不耐受高压氧治疗的患者。
Objective Prospective observation was applied to investigate the clinical efficacy of intratympanic administration of glucocorticoid(ITG)in patients with sudden sensorineural hearing loss(SSNHL)who were refractory to routine drug treatment under the situations of hyperbaric oxygen(HBO)intolerance.Methods Patients who did not adequately benefit from systemic treatment were evaluated retrospectively.Refractory patients were offered either ITG(28 cases)or HBO(34 cases)therapy,according to their HBO intolerance.The hearing threshold of both groups were evaluated before and after the therapy.The ITG group aged 31~81years(mean 52.54±10.90 years)was treated with intratympanic methylprednisolone injection(20 mg methylprednisolon in 0.5 ml saline),once every other day,five times.Another group with a mean age of 54.09±8.24 years(41~68 years)was accepted HBO therapy once-daily for 10 days.Results Hearing threshold in patients treated with ITG(65.54±18.17 dB)decreaced 18.54±13.87 dBHL,2 patients was recovered,5 patients had apparent recovery,4 had effective recovery and 21 had no recovery,the total effective number was 11 cases,and the total effective rate was 39.29%.Meanwhile,hearing threshold in patients treated with HBO(67.21±18.36 dB)had an reduction of 17.26±12.77 dB,the numbers of recovery,remarkable effect,effect and inefficacy after treatment were 4,5,4 and 21 cases respectively,the total effective number was 13,and the total effective rate was 38.24%.There was no significant difference between the two groups.Conclusion Both ITG and HBO therapy can improve hearing threshold of patients with refractory SSNHL.ITG may be used in the patients who cannot endure HBO therapy.
作者
李曼
袁东升
刘建兵
董晓斌
颜小梅
蔡跃峰
柏正群
佘万东
Li Man;Yuan Dongsheng;Liu Jianbing;Dong Xiaobin;Yan Xiaomei;Cai Yuefeng;Bai Zhengqun;She Wandong(Department of Otolaryngology,Yancheng City Dafeng People's Hospital,Dafeng,224100,China)
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2018年第4期343-346,共4页
Journal of Audiology and Speech Pathology
基金
国家自然科学基金项目(81670931)
江苏省临床医学科技专项(BL2014002)
关键词
突发性聋
糖皮质激素
鼓室注射
高压氧
Sudden sensorineural hearing loss
Glucocorticoid
Intratympanic injection
Hyperbaric oxygen
