鼓室注射地塞米松与耳后骨膜下注射甲强龙治疗突发性聋的疗效及不良反应对比

发布时间：2018-04-16 10:15

本文选题：聋 + 突发性　；参考：《临床耳鼻咽喉头颈外科杂志》2017年16期

【摘要】：目的:研究对比鼓室注射地塞米松与耳后骨膜下注射甲强龙治疗突发性聋的有效性及相关并发症。方法:将108例单侧突发性聋患者随机分为A组和B组各54例,分别行鼓室注射地塞米松(10mg/ml)和耳后骨膜下注射甲强龙(40mg/ml)治疗,均隔天给药1次,共5次,随访3个月,研究分析治疗前后纯音听阈值改变情况、耳鸣致残量表(THI)评分、眩晕障碍量表(DHI)评分、有无鼓膜穿孔、局部感染及血糖改变情况。结果:(1)两组间总体有效率及纯音听阈值好转程度无统计学差异(P0.05),两组间低频型突发性聋患者纯音听阈好转程度有统计学差异(P0.05);(2)两组间THI分值减少无统计学差异(P0.05),两组间高频型突发性聋患者THI减少程度有统计学差异(P0.05);(3)两组间DHI分值减少无统计学差异(P0.05);(4)两组治疗前、后空腹血糖均无统计学差异(P0.05);(5)A组治疗结束后2周有2例出现鼓膜穿孔,随访结束时穿孔愈合,两组均无耳部感染患者。结论:两种治疗方法均能改善单侧突发性聋患者的纯音听阈值,能有效减轻眩晕及耳鸣对患者的影响,鼓室注射地塞米松能更好地减小高频型突发性聋患者THI评分,耳后骨膜下注射可更好地改善低频型患者的纯音听阈,两种给药方式均对患者血糖无明显影响,但鼓室注射地塞米松存在鼓膜穿孔的风险。
[Abstract]:Objective: to compare the efficacy and complications of dexamethasone injection in tympanic chamber and subosseous injection of methylenolone in the treatment of sudden deafness.Methods: one hundred and eight patients with unilateral sudden deafness were randomly divided into two groups: group A (n = 54) and group B (n = 54). They were treated with dexamethasone 10 mg / ml in tympanic chamber and 40 mg / ml in subauricular periosteum respectively. All patients were treated once every other day for 5 times and followed up for 3 months.The changes of pure tone hearing threshold before and after treatment, tinnitus disability scale (THI), dizziness scale (DHI), tympanic membrane perforation, local infection and changes of blood glucose were analyzed.Results there was no significant difference in the total effective rate and the improvement of pure tone auditory threshold between the two groups (P 0.05). There was a significant difference in the improvement of pure tone hearing threshold between the two groups (P < 0.05). There was no significant difference in the THI scores between the two groups (P 0.05).There was significant difference in the reduction of THI between the two groups (P < 0.05). There was no significant difference in the DHI score between the two groups (P < 0.05) before treatment, there was no significant difference between the two groups.There was no significant difference in fasting blood glucose after treatment in group A 2 cases had perforation of tympanic membrane 2 weeks after treatment and the perforation healed at the end of follow-up. There were no cases of ear infection in both groups.Conclusion: both methods can improve the threshold of pure tone hearing in patients with unilateral sudden deafness and can effectively reduce the effects of vertigo and tinnitus. The THI score of patients with high frequency sudden deafness can be better reduced by injecting dexamethasone into tympanic chamber.Subperiosteal injection of retroauricular injection could improve the pure tone hearing threshold of patients with low frequency. Both methods had no significant effect on blood glucose, but dexamethasone injection in tympanic chamber had the risk of tympanic membrane perforation.
【作者单位】：眉山市人民医院耳鼻喉科;
【分类号】：R764.437

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