鼓室内与静脉注射地塞米松治疗突发性聋疗效比较

Efficacy Analysis of Intratympanic and Intravenous Dexamethasone in Idiopathic Sudden Sensorineural Hearing Loss

付丽艳;刘卓慧;龙瑞清;

1:江西德兴市人民医院耳鼻咽喉科

2:昆明医科大学第一附属医院耳鼻咽喉头颈外科

摘要
目的探讨鼓室内与静脉注射激素治疗突发性聋的疗效。方法 121例单耳突发性聋患者进行前瞻性随机对照研究,分为治疗组(60例,地塞米松35mg鼓室内注射,1次/天,连续7d)和对照组(61例,地塞米松10mg/d静脉滴注,持续35mg鼓室内注射,1次/天,连续7d)和对照组(61例,地塞米松10mg/d静脉滴注,持续35d),并于治疗前及治疗后第1、4及8w行纯音听阈测试,比较两组治疗后的有效率;并分别比较两组低频下降型、高频下降型及全频下降型患者之间治疗后气导听力提高值及3型之间总体听力提高值。结果 (1)治疗后1周治疗组痊愈11例,显效15例,有效20例,总有效率76.7%(46/60);对照组痊愈9例,显效16例,有效18例,总有效率71.67%(43/60),两组间总有效率比较差异无统计学意义(P>0.05)。治疗后4w及8w,两组间总有效率比较差异均无统计学意义(P>0.05)。(2)治疗后8w治疗组低频下降型及高频下降型突聋患者听力提高值分别为26.35±4.77及17.04±9.60dB,对照组分别为20.60±3.60及14.08±7.43dB,治疗组疗效较对照组更优(P<0.05)。(3)两组合计治疗后低频下降型突发性聋患者听力提高值(23.48±4.52dB)明显优于高频下降型(15.39±8.97dB)及全频下降型(10.73±7.11dB)(P<0.01)。结论连续1周每日鼓室内注射地塞米松治疗突发性聋是一种安全有效的方法,对于低频及高频下降型突发性聋患者,其较静脉给药疗效更优,值得临床推广。
关键词
突发性聋;鼓室内注射;地塞米松
基金项目(Foundation):
国家自然科学基金(81660175)项目
作者
付丽艳;刘卓慧;龙瑞清;
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付丽艳刘卓慧龙瑞清