全身应用联合鼓室注射糖皮质激素治疗重度和极重度突发性聋

Combined Intratympanic and Systemic Use of Glucocorticoid for the Treatment of Severe to Profound Idiopathic Sudden Sensorineural Hearing Loss

张志坚;华清泉;王新春;廖华;

1:武汉大学人民医院耳鼻咽喉-头颈外科

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摘要

目的比较全身应用联合鼓室注射糖皮质激素与单独全身应用糖皮质激素治疗重度和极重度突发性聋的疗效。方法回顾性比较47例(47耳)重度和极重度突聋患者的临床资料和治疗效果,将患者分为口服糖皮质激素组(口服组,19例,晨起顿服强的松片1mg.kg-1.d-1,5天后每2天递减10mg)、口服加鼓室内注射糖皮质激素组[口服加鼓室给药组,9例,在口服强的松片(用法同口服组)的同时鼓室内注入地塞米松5mg,隔2天一次,平均4次]、静脉滴注糖皮质激素组(静滴组,12例,静脉滴注地塞米松10mg,每日一次,每隔5日减半量)和静脉滴注加鼓室内注射糖皮质激素组(静滴加鼓室给药组,7例,方法、剂量同静滴组及上述鼓室给药法)。疗程结束后,比较各组的疗效。结果口服组和口服加鼓室给药组的总有效率分别为52.63%和66.67%,显效率分别为36.84%和22.22%,两组间的总有效率和显效率差异均无统计学意义(P>0.05)。静滴组和静滴加鼓室给药组的总有效率分别为83.33%和71.43%,显效率分别为66.67%和71.43%,两组间的总有效率和显效率差异均无统计学意义(P>0.05)。结论全身应用(口服或静滴)联合鼓室内注射糖皮质激素治疗重度和极重度突聋并不能得到较全身单独用药更好的疗效。

关键词

突发性聋;糖皮质激素;鼓室注药;全身用药;联合治疗

基金项目(Foundation):

作者

张志坚;华清泉;王新春;廖华;

参考文献

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