糖皮质激素的不同给药途径及时机对重度和极重度突发性聋疗效的影响

Effect of Different Route and Timing of Administration of Glucocorticoid on the Efficacy for Treatment of Severe or Profound Idiopathic Sudden Sensorineural Hearing Loss

张志坚;王新春;廖华;华清泉;

1:武汉大学人民医院耳鼻咽喉-头颈外科

摘要
目的评价糖皮质激素的3种不同给药途径和用药时机对治疗重度和极重度突发性聋疗效的影响。方法根据糖皮质激素给药途径,将43例(43耳)重度和极重度突聋患者分为口服组(n=19)、静脉给药组(n=14)和鼓室内给药组(n=10),分别采取晨起口服强的松片、静脉滴注和鼓室内注射地塞米松的给药途径,其余治疗均相同;根据发病后接受糖皮质激素治疗的时机,将43例患者分为2周内组(n=37)和2周后组(n=6),比较不同给药途径及时机各组间疗效。结果鼓室内给药组,静脉给药组和口服组的总有效率分别为70.00%、78.57%和52.63%,显效率分别为60.00%、57.14%和36.84%,3组间的总有效率和显效率差异均无统计学意义(P>0.05)。2周内组和2周后组的显效率分别为56.76%和0.00%,总有效率分别为72.97%和16.67%,2周内组的显效率和总有效率均明显高于与2周后组(P<0.05)。结论作为重度极重度突聋患者的初始(一线)治疗,糖皮质激素的不同给药途径(鼓室内给药、静脉滴注和口服)对疗效无影响;开始糖皮质激素治疗的时机与疗效密切相关,越早使用则疗效越好,最好在发病后2周内开始用药。
关键词
突发性聋;糖皮质激素;给药途径
基金项目(Foundation):
作者
张志坚;王新春;廖华;华清泉;
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张志坚王新春廖华华清泉