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地塞米松对乳突根治术致高频感音性听力损伤的防护作用

Application of Dexamethasone Reduces Sensorineural High Frequency Hearing Loss after Mastoidectomy

唐凌媛;熊敏;付晓燕;刘雲;赖晃文;杨传红;李彩红;

1:南方医科大学

2:广州总医院

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摘要

目的探讨地塞米松对开放式乳突根治术后高频感音性听力损伤的保护作用。方法将76例(76耳)胆脂瘤中耳炎行开放式乳突根治术患者随机分为地塞米松组和非地塞米松组,每组38例,地塞米松组术中将浸有地塞米松(5 mg/ml)的明胶海绵置于圆窗表面,术后立即静脉滴注地塞米松5 mg/50 kg,非地塞米松组术中及术后均不使用地塞米松,其余治疗相同。分别于开放式乳突根治术前和术后90天行纯音听阈检测,比较两组患者术前和术后纯音听阈的变化。结果两组对象手术前各频率骨导听阈差异无统计学意义(P>0.05);地塞米松组术后6 kHz的骨导听阈较术前提高8.3±3.9 dB,8 kHz提高11.3±5.2 dB,高频(4、6、8 kHz)平均听阈提高10.1±7.2 dB;而非地塞米松组6 kHz骨导听阈较术前提高13.7±4.6 dB,8 kHz提高25.1±5.4 dB,高频平均听阈提高19.3±9.7 dB,两组患者在6 kHz(P=0.039)、8 kHz(P=0.007)和高频平均听阈(P=0.009)比较差异有统计学意义。结论术中圆窗联合术后静脉应用地塞米松能显著减轻开放式乳突根治术后高频(6、8 kHz)感音性听力损伤;建议开放式乳突根治术后应用地塞米松,以预防手术电钻声可能导致的高频感音性听力损伤。

关键词

开放式乳突根治术;感音性听力减退;地塞米松

基金项目(Foundation):

国家自然科学基金(81470702)资助

作者

唐凌媛;熊敏;付晓燕;刘雲;赖晃文;杨传红;李彩红;

参考文献

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开放式乳突根治术感音性听力减退地塞米松

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唐凌媛熊敏付晓燕刘雲赖晃文杨传红李彩红