鼓室内应用地塞米松补救性治疗难治性突发性聋相关文献的Meta分析

A Meta-analysis of Intratympanic Dexamethasone as a Salvage Treatment for Sudden Sensorineural Hearing Loss

魏浩;陆玲;王茂华;王凯健;董健菲;喻唯唯;高松;李依寒;高下;钱晓云;

1:南京医科大学鼓楼临床医学院耳鼻咽喉头颈外科

2:南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科

3:中南大学湘雅二医院耳鼻咽喉头颈外科

4:江苏大学附属镇江市第一人民医院耳鼻咽喉科

摘要
目的探讨鼓室内不同给药方式应用地塞米松补救性治疗难治性突发性聋的疗效。方法通过关键词在中国知网、万方、维普、CBM、Pubmed、Medline、Embase、Cochrane等中英文数据库检索2005~2018年国内外公开发表的鼓室内与全身应用糖皮质激素补救性治疗难治性突发性聋的相关文献,使用RevMan5.3软件对各研究的原始数据中疗效、给药方式等指标进行Meta分析,比值比(odds ratio,OR)值和95%CI作为本研究的效应指标,异质性检验的指标选用I2和P值。结果本研究共检索756篇文献,最终纳入符合标准的文献12篇,均为英文,共收集病例数836例;其中7篇文献报道鼓室内给药的不良反应,如眩晕、耳鸣等,均可在休息或停药后缓解,鼓室内或全身给药方式中均未出现听力下降、肝肾损害等不良反应。Meta分析显示鼓膜穿刺组疗效明显高于全身用药组(P<0.01,OR=4.59,95%CI为2.83~7.46),鼓室置管组疗效明显高于全身用药组(P<0.01,OR=4.30,95%CI为2.39~7.72),圆窗置管组疗效明显高于全身用药组(P<0.01,OR=8.22,95%CI为3.32~20.34),圆窗置管组疗效高于鼓室置管组(P<0.05,OR=3.55,95%CI为1.35~9.35)。结论对于全身治疗效果欠佳的难治性突发性聋患者,糖皮质激素鼓室内给药可作为有效的补救性治疗方式,鼓室内圆窗置管给药听力恢复疗效优于鼓室置管给药途径。
关键词
地塞米松;鼓室内给药;难治性突发性聋;Meta分析
基金项目(Foundation):
江苏省第十四批“六大人才高峰”高层次人才项目(YY-073);; 南京市卫生青年人才培养工程项目(第一层次)(QRX17012)
作者
魏浩;陆玲;王茂华;王凯健;董健菲;喻唯唯;高松;李依寒;高下;钱晓云;
参考文献

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