摘要
目的分析甲泼尼龙耳后局部注射与全身用药在低频下降型突发性耳聋(SHL)分型治疗中的疗效。方法选取2016年1月至2018年12月就诊的78例低频下降型SHL患者,分为激素全身治疗组(A组)和激素耳后注射组(B组)。A组采用甲泼尼龙80 mg静脉滴注,每天1次,连用3 d,后续40 mg静脉滴注,每天1次,连用4 d。B组采用甲泼尼龙40 mg耳后筛区骨膜下注射,每2天1次,两组均同时联合基础治疗至听力恢复正常或治疗14 d,分别于治疗后7、14 d行纯音测听检查,分析听阈变化情况,对患者的听力疗效进行分析。结果治疗后7、14 d两组听力阈值均较治疗前降低,治疗后7 d A、B两组听力提高值分别为(14.59±10.00)、(19.50±8.53)dB,总有效率分别为51.28%、74.36%,差异有统计学意义(P<0.05)。治疗后14 d A、B两组听力提高值分别为(20.27±9.32)、(22.22±8.23)dB,总有效率分别为79.49%、82.05%,差异无统计学意义(P>0.05)。结论低频下降型SHL患者中,激素局部用药与全身给药治疗均有效,但激素局部注射可早于全身激素治疗达到临床疗效。
Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of low frequency descending sudden hearing loss(SHL).Methods A total of 78 patients with low frequency descending SHL from January 2016 to December 2018 were selected and divided into the systemic application group(group A)and the topical injection(group B).Group A received intravenous infusion of methylprednisolone 80 mg/d for 3 days,then 40 mg/d for next 4 days,while group B received postauricular injection of methylprednisolone 40 mg/2 d,both groups were treated until the hearing was restored to normal or 14 days after treatment,pure tone audiometry was performed on the 7th and 14th day,analyzed changes in hearing threshold and the effect.Results Compared with before treatment,the hearing threshold decreased in the two groups on the 7th and 14th day.On the 7th day,the increase of hearing threshold in group A and B was(14.59±10.00),(19.50±8.53)dB respectively,the total effective rate was 51.28%and 74.36%respectively,the difference was statistically significant(P<0.05).On the 14th day,the increase of hearing threshold in group A and B was(20.27±9.32),(22.22±8.23)dB respectively,the total effective rate was 79.49%and 82.05%respectively,there was no statistically significant difference(P>0.05).Conclusion Topical injection and systemic application are all effective in patients with low frequency descending SHL,while topical injection may achieve clinical efficacy earlier than systemic application.
作者
蒋中莉
钟时勋
JIANG Zhongli;ZHONG Shixun(Department of Otolaryngology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Otolaryngology,Hechuan District People′s Hospital,Chongqing 401520,China)
出处
《重庆医学》
CAS
2020年第2期277-279,289,共4页
Chongqing medicine
关键词
听觉丧失
突发性
糖皮质激素类
耳后注射
hearing loss
sudden
glucocorticoids
retroauricular injection
作者简介
蒋中莉(1986-),主治医师,硕士,主要从事耳科学研究;通信作者:钟时勋,E-mail:zhongsx@sohu.com。
