激素三种不同给药方式治疗突发性耳聋的疗效比较

发布时间：2018-06-11 22:21

本文选题：突发性耳聋 + 鼓室注射　；参考：《安徽医科大学》2015年硕士论文

【摘要】：目的探讨糖皮质激素三种给药途径治疗突发性耳聋疗效的比较.方法选取2013年8月至2014年6月在安徽医科大学第一附属医院耳鼻咽喉-头颈外科住院治疗突发性耳聋的患者90例,按照住院顺序随机分为A、B、C三组,每组在应用扩张血管、营养神经治疗药物的基础上,A组加用口服甲泼尼龙琥珀酸钠片,B组加用静脉滴注甲泼尼龙琥珀酸钠注射液,C组加用鼓室注射甲泼尼龙琥珀酸钠注射液,在治疗前及治疗后一个月分别行纯音测听检查。结果A组患者痊愈6例,显效4例,有效6例,总有效率为53.3%(16/30)。B组患者痊愈7例,显效2例,有效7例,总有效率53.3%(16/30)。C组患者痊愈8例,显效7例,有效6例,总有效率70%(21/30)。A、B、C组患者听力的平均提高值分别为16.1±15.3 d B,14.3±12.7 d B,21.6±20.4 d B。C组总有效率及听力平均提高值与A、B组比较有统计学意义(p0.05)。A组和B组的总有效率及听力平均提高值无统计学意义(p0.05)。在重度突发性耳聋的患者中,鼓室注射激素使患者的平均听力提高为27.2±23.5 d B大于A组的14.4±13.9 d B及B组的15.1±12.6 d B。在治疗过程中无中耳炎、鼓膜穿孔、听力进一步下降等并发症发生。结论鼓室注射治疗突发性耳聋的疗效优于全身用药,对于初发的突发性耳聋患者、全身应用激素有禁忌症以及重度突发性耳聋的患者推荐使用鼓室注射治疗方法。
[Abstract]:Objective to compare the efficacy of glucocorticoid in the treatment of sudden deafness. Methods from August 2013 to June 2014, 90 patients with sudden deafness were enrolled in otolaryngal-head and neck surgery, first affiliated Hospital of Anhui Medical University, and were randomly divided into three groups according to the order of hospitalization. Group A was treated with oral methylprednisolone sodium succinate tablets and group B was treated with intravenous injection of methylprednisolone sodium succinate injection and group C was injected with methylprednisolone sodium succinate injection in tympanic chamber. Pure tone audiometry was performed before treatment and one month after treatment. Results in group A, 6 cases were cured, 4 cases were markedly effective, 6 cases were effective. The total effective rate was 53.3%. The total effective rate was 53.3%, 2 cases and 7 cases, respectively. The total effective rate was 53.3% 16 / 30%, 8 cases were cured, 7 cases were markedly effective and 6 cases were effective. The total effective rate and the average improvement of hearing in group C were 16.1 卤15.3 days, 14.3 卤12.7 days, and 21.6 卤20.4 days, respectively. There was no significant difference between group A and group B in the total effective rate and the average improvement of hearing. There was no significant difference in total effective rate and average improvement of hearing between group A and group B (P 0.05). In the patients with severe sudden deafness, the average hearing of patients with severe sudden deafness was 27.2 卤23.5 dB, 14.4 卤13.9 dB and 15.1 卤12.6 dB, respectively. No complications such as otitis media, tympanic membrane perforation and further hearing loss occurred during the treatment. Conclusion the therapeutic effect of tympanic injection on sudden deafness is better than that of whole body medication. For the patients with primary sudden deafness, the patients with systemic hormone taboo and severe sudden deafness should be treated with tympanic injection.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R764.437

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