鼓室置管灌注甲泼尼龙挽救性治疗突发性聋的疗效观察

The Evaluation of Intratympanic Methylprednisolone Perfusion as a Salvage Treatment for Sudden Sensorineural Hearing Loss

戴艳红;佘万东;杜小平;俞晨杰;崔昕燕;王俊国;朱文燕;

1:南京大学医学院附属鼓楼医院耳鼻咽喉科

2:美国俄克拉荷马市Hough耳研究所

摘要
目的探讨经鼓室置管灌注甲泼尼龙挽救性治疗突发性聋的疗效。方法选择常规治疗至少一个疗程(10天)无效的突发性聋患者,根据患者的意愿分成两组:治疗组19例(19耳),对照组20例(20耳),治疗组鼓室置管灌注甲泼尼龙20mg,每日1次,同时两组均继续常规治疗,但不再继续全身应用糖皮质激素;两组均继续治疗10天。治疗后第3个月比较两组的听力恢复情况。结果治疗组:痊愈2例,显效3例,有效4例,无效10例,总有效率47.4%,受损频率PTA平均改善14.0±16.0dB;对照组:显效1例,有效4例,无效15例,总有效率25.0%,受损频率PTA平均改善6.4±10.2dB,两组总有效率及平均PTA改善值比较,差异均无统计学意义(P=0.262,P=0.083)。治疗组发病至开始灌注的平均时间间隔50.2±55.4天;对照组发病至继续常规治疗的平均时间间隔:13.8±3.3天,治疗组长于对照组(P<0.05);治疗组内有效组和无效组的发病至开始灌注的平均时间间隔分别为23.5±14.6、13.8±3.3天,有效组短于无效组(P<0.05)。仅将发病至继续治疗的时间间隔≤60天的病例纳入分析,则实验组和对照组的受损频率平均PTA改善值分别是16.8和6.4dB,实验组优于对照组(P=0.029)。治疗组未发生永久性鼓膜穿孔、听力损失进一步加重等并发症。结论常规治疗无效后尽早选择鼓室置管灌注甲泼尼龙挽救性治疗突发性聋是安全的,可能会获得一定的有效率。
关键词
鼓室灌注;突发性聋;甲泼尼龙
基金项目(Foundation):
南京市医学科技发展项目(编号:YKK-05098)
作者
戴艳红;佘万东;杜小平;俞晨杰;崔昕燕;王俊国;朱文燕;
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